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Open Access 01-12-2011 | Research

Mild hypoglycemia is strongly associated with increased intensive care unit length of stay

Authors: James Krinsley, Marcus J Schultz, Peter E Spronk, Floris van Braam Houckgeest, Johannes P van der Sluijs, Christian Mélot, Jean-Charles Preiser

Published in: Annals of Intensive Care | Issue 1/2011

Abstract

Background

Hypoglycemia is associated with increased mortality in critically ill patients. The impact of hypoglycemia on resource utilization has not been investigated. The objective of this investigation was to evaluate the association of hypoglycemia, defined as a blood glucose concentration (BG) < 70 mg/dL, and intensive care unit (ICU) length of stay (LOS) in three different cohorts of critically ill patients.

Methods

This is a retrospective investigation of prospectively collected data, including patients from two large observational cohorts: 3,263 patients admitted to Stamford Hospital (ST) and 2,063 patients admitted to three institutions in The Netherlands (NL) as well as 914 patients from the GLUCONTROL trial (GL), a multicenter prospective randomized controlled trial of intensive insulin therapy.

Results

Patients with hypoglycemia were more likely to be diabetic, had higher APACHE II scores, and higher mortality than did patients without hypoglycemia. Patients with hypoglycemia had longer ICU LOS (median [interquartile range]) in ST (3.0 [1.4-7.1] vs. 1.2 [0.8-2.3] days, P < 0.0001), NL (5.2 [2.6-10.3] vs. 2.0 [1.3-3.2] days, P < 0.0001), and GL (9 [5-17] vs. 5 [3-9] days, P < 0.0001). For the entire cohort of 6,240 patients ICU LOS was 1.8 (1.0-3.3) days for those without hypoglycemia and 3.0 (1.5-6.7) days for those with a single episode of hypoglycemia (P < 0.0001). This was a consistent finding even when patients were stratified by severity of illness or survivor status. There was a strong positive correlation between the number of episodes of hypoglycemia and ICU LOS among all three cohorts.

Conclusions

This multicenter international investigation demonstrated that hypoglycemia was consistently associated with significantly higher ICU LOS in heterogeneous cohorts of critically ill patients, independently of severity of illness and survivor status. More effective methods to prevent hypoglycemia in these patients may positively impact their cost of care.

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Title: Mild hypoglycemia is strongly associated with increased intensive care unit length of stay
Authors: James Krinsley
Marcus J Schultz
Peter E Spronk
Floris van Braam Houckgeest
Johannes P van der Sluijs
Christian Mélot
Jean-Charles Preiser
Publication date: 01-12-2011
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2011
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/2110-5820-1-49

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mild hypoglycemia is strongly associated with increased intensive care unit length of stay

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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