Association Between Hyperglycemia and Hospital Length of Stay in Patients Undergoing Hematopoietic Stem Cell Transplantation

作者：Rentschler Lindsey M; Swarts Sarah J; Bierman Philip J; Devetten Marcel P; Stoner Julie A; Puumala Susan E; Goldner Whitney S^*

来源：Endocrinologist, 2010, 20(5): 232-235.

DOI：10.1097/TEN.0b013e3181f47dbc

• hyperglycemia
• hematopoietic stem cell transplant
• insulin
• intensive glycemic control
• TPN

Patients undergoing hematopoietic stem cell transplantation (HSCT) are at high risk for hospital-related hyperglycemia due to chemotherapy, corticosteroids, and total parenteral nutrition (TPN). The prevalence of hyperglycemia and its association with complications or length of stay (LOS) is not well studied in this population.
A retrospective review of 173 patients admitted for HSCT was conducted. Hospital-related hyperglycemia was consistent with American Diabetes Association criteria: >= 2 fasting blood glucoses >= 126 mg/dL or 1 blood glucose >= 200 mg/dL. End points were as follows: renal, cardiac, or infectious complications; graft versus host disease; LOS; and overall survival. Of the 160 patients without pre-existing diabetes, 71% were hyperglycemic. Fifty-four percent of hyperglycemic and 4% of nonhyperglycemic patients received TPN (P < 0.0001). Among the 61 hyperglycemic patients given TPN, 41% developed hyperglycemia while receiving TPN. Hospital-related hyperglycemia was also associated with increased complications (56% vs. 39%, P = 0.05). Median age was higher among hyperglycemic compared with nonhyperglycemic subjects. LOS was increased among subjects who developed complications, but was not associated with development of hyperglycemia after adjustment for confounding complication and treatment variables.
TPN and increasing age are both risk factors for the development of hospital-related hyperglycemia in HSCT patients. Hyperglycemia is associated with increased risk of complications but was not associated with longer LOS.

• 出版日期2010-10