Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study

Introduction: Initial or at-admission hyperglycaemia is a risk marker of morbidity and mortality in many acute critical illnesses. There has been no study to evaluate hyperglycaemia in severe sepsis and septic shock in the emergency department setting. Objectives: To investigate whether hypergly...

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Main Author:	Azil , Azlizawati
Format:	Thesis
Language:	English
Published:	2015
Subjects:	RA Public aspects of medicine
Online Access:	http://eprints.usm.my/40112/1/Dr._Azlizawati_Azil_%28Emergency_Medicine%29-24_pages.pdf
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spelling	my-usm-ep.401122018-05-23T07:37:06Z Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study 2015 Azil , Azlizawati RA Public aspects of medicine Introduction: Initial or at-admission hyperglycaemia is a risk marker of morbidity and mortality in many acute critical illnesses. There has been no study to evaluate hyperglycaemia in severe sepsis and septic shock in the emergency department setting. Objectives: To investigate whether hyperglycaemia detected during patient initial presentation to emergency department has prognostic value in the outcome of severe sepsis and septic shock patients and compare it with other prognostic factors. Methods: A retrospective study in patients with severe sepsis and septic shock presented to the Red Zone of Emergency Department of Hospital University of Science Malaysia during 2008- 2011 was done. Data were collected by tracing patients medical records based on the attendance registry. Demographic data, initial capillary blood glucose and other factors which may predict the outcomes of severe sepsis and septic shock were collected and recorded. Results: Data were collected from 495 patients with severe sepsis and septic shock. The prevalence of stress hyperglycaemia was 14.9% and the overall initial hyperglycaemia was 40.2%. Initial hyperglycaemia did have significant prognostic value in determining mortality in non-diabetic patients (Chi-square 32.7% vs. 59.1%, p-value 0.001). No significant correlations were found between initial hyperglycaemia with prolonged hospital stay. However when multivariate analysis were done only high mMEDs score, lactate level and mechanical ventilator were associated with mortality and for prolonged length of stay only mMEDs score. Conclusion: Initial hyperglycaemia has prognostic value in determining mortality in non-diabetic but not in diabetic patients. No correlation can be made between initial hyperglycaemia and prolonged length of stay, as predicting length of stay is a complex nature and cannot be determined by single factor. When compared with other prognostic factors such as mMEDS score, lactate and ventilator use; hyperglycaemia was found to be inferior. 2015 Thesis http://eprints.usm.my/40112/ http://eprints.usm.my/40112/1/Dr._Azlizawati_Azil_%28Emergency_Medicine%29-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RA Public aspects of medicine
spellingShingle	RA Public aspects of medicine Azil , Azlizawati Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study
description	Introduction: Initial or at-admission hyperglycaemia is a risk marker of morbidity and mortality in many acute critical illnesses. There has been no study to evaluate hyperglycaemia in severe sepsis and septic shock in the emergency department setting. Objectives: To investigate whether hyperglycaemia detected during patient initial presentation to emergency department has prognostic value in the outcome of severe sepsis and septic shock patients and compare it with other prognostic factors. Methods: A retrospective study in patients with severe sepsis and septic shock presented to the Red Zone of Emergency Department of Hospital University of Science Malaysia during 2008- 2011 was done. Data were collected by tracing patients medical records based on the attendance registry. Demographic data, initial capillary blood glucose and other factors which may predict the outcomes of severe sepsis and septic shock were collected and recorded. Results: Data were collected from 495 patients with severe sepsis and septic shock. The prevalence of stress hyperglycaemia was 14.9% and the overall initial hyperglycaemia was 40.2%. Initial hyperglycaemia did have significant prognostic value in determining mortality in non-diabetic patients (Chi-square 32.7% vs. 59.1%, p-value 0.001). No significant correlations were found between initial hyperglycaemia with prolonged hospital stay. However when multivariate analysis were done only high mMEDs score, lactate level and mechanical ventilator were associated with mortality and for prolonged length of stay only mMEDs score. Conclusion: Initial hyperglycaemia has prognostic value in determining mortality in non-diabetic but not in diabetic patients. No correlation can be made between initial hyperglycaemia and prolonged length of stay, as predicting length of stay is a complex nature and cannot be determined by single factor. When compared with other prognostic factors such as mMEDS score, lactate and ventilator use; hyperglycaemia was found to be inferior.
format	Thesis
qualification_level	Master's degree
author	Azil , Azlizawati
author_facet	Azil , Azlizawati
author_sort	Azil , Azlizawati
title	Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study
title_short	Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study
title_full	Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study
title_fullStr	Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study
title_full_unstemmed	Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study
title_sort	hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, hospital universiti sains malaysia: a retrospective study
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2015
url	http://eprints.usm.my/40112/1/Dr._Azlizawati_Azil_%28Emergency_Medicine%29-24_pages.pdf
_version_	1747820783151874048

Hyperglycaemia as a predictor of mortality and prolonged length of stay in severe sepsis and septic shock patients presented to red zone of emergency department, Hospital Universiti Sains Malaysia: a retrospective study

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