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Major findings: TPN-induced hyperglycemia is associated with longer hospital stay, more complications, and higher mortality rates.
Data source: A review of 276 adult medical and surgical patients who received TPN at a single hospital.
Disclosures: Co-author Dr. Guillermo Umpierrez has received research support from the American Diabetes Association and the National Institutes of Health. The other researchers had no financial conflicts to disclose.
Hyperglycemia caused by total parenteral nutrition is significantly associated with increased length of stay, risk of complications, and mortality, according to a study of 276 hospitalized adults.
Furthermore, the best predictors of death and complications in total parenteral nutrition (TPN) patients were blood glucose levels both before and within the first 24 hours of TPN, said Dr. Francisco J. Pasquel of Emory University, Atlanta, and his colleagues.
In this study, the researchers reviewed data from 276 consecutive patients at a single hospital. The average age of the patients was 51 years, and 19% had diabetes before entering the hospital. The patients received TPN for an average of 15 days, and most (65%) were surgical patients (Diabetes Care 2009 Dec. 29 [doi: 10.2337/dc09-1748
After the researchers controlled for age, sex, and diabetes history, mortality was significantly associated with a pre-TPN blood glucose level of 121-150 mg/dL, 151-180 mg/dL, or greater than 180 mg/dL. In addition, blood glucose within 24 hours of TPN was a significant predictor of mortality. Compared with patients who did not die, deceased patients had significantly higher blood glucose within 24 hours of TPN (162 mg/dL vs. 139 mg/dL) and during days 2-10 of TPN (161 mg/dL vs. 142 mg/dL).
Patients with blood glucose greater than 180 mg/dL within 24 hours of TPN were more than three times as likely to develop pneumonia and more than twice as likely to develop acute renal failure, compared with patients with blood glucose levels below 120 mg/dL.
In addition, patients with higher blood glucose levels during TPN treatment spent significantly more time in both the ICU and the hospital compared with patients with lower blood glucose levels.
The results suggest that early intervention against hyperglycemia may improve outcomes for TPN patients.
“Our study indicates that blood glucose values prior to and within 24 hours of TPN are better predictors of hospital mortality and complications than the mean blood glucose during the entire duration of TPN,” the researchers said.
Major findings: TPN-induced hyperglycemia is associated with longer hospital stay, more complications, and higher mortality rates.
Data source: A review of 276 adult medical and surgical patients who received TPN at a single hospital.
Disclosures: Co-author Dr. Guillermo Umpierrez has received research support from the American Diabetes Association and the National Institutes of Health. The other researchers had no financial conflicts to disclose.
Hyperglycemia caused by total parenteral nutrition is significantly associated with increased length of stay, risk of complications, and mortality, according to a study of 276 hospitalized adults.
Furthermore, the best predictors of death and complications in total parenteral nutrition (TPN) patients were blood glucose levels both before and within the first 24 hours of TPN, said Dr. Francisco J. Pasquel of Emory University, Atlanta, and his colleagues.
In this study, the researchers reviewed data from 276 consecutive patients at a single hospital. The average age of the patients was 51 years, and 19% had diabetes before entering the hospital. The patients received TPN for an average of 15 days, and most (65%) were surgical patients (Diabetes Care 2009 Dec. 29 [doi: 10.2337/dc09-1748
After the researchers controlled for age, sex, and diabetes history, mortality was significantly associated with a pre-TPN blood glucose level of 121-150 mg/dL, 151-180 mg/dL, or greater than 180 mg/dL. In addition, blood glucose within 24 hours of TPN was a significant predictor of mortality. Compared with patients who did not die, deceased patients had significantly higher blood glucose within 24 hours of TPN (162 mg/dL vs. 139 mg/dL) and during days 2-10 of TPN (161 mg/dL vs. 142 mg/dL).
Patients with blood glucose greater than 180 mg/dL within 24 hours of TPN were more than three times as likely to develop pneumonia and more than twice as likely to develop acute renal failure, compared with patients with blood glucose levels below 120 mg/dL.
In addition, patients with higher blood glucose levels during TPN treatment spent significantly more time in both the ICU and the hospital compared with patients with lower blood glucose levels.
The results suggest that early intervention against hyperglycemia may improve outcomes for TPN patients.
“Our study indicates that blood glucose values prior to and within 24 hours of TPN are better predictors of hospital mortality and complications than the mean blood glucose during the entire duration of TPN,” the researchers said.
Major findings: TPN-induced hyperglycemia is associated with longer hospital stay, more complications, and higher mortality rates.
Data source: A review of 276 adult medical and surgical patients who received TPN at a single hospital.
Disclosures: Co-author Dr. Guillermo Umpierrez has received research support from the American Diabetes Association and the National Institutes of Health. The other researchers had no financial conflicts to disclose.
Hyperglycemia caused by total parenteral nutrition is significantly associated with increased length of stay, risk of complications, and mortality, according to a study of 276 hospitalized adults.
Furthermore, the best predictors of death and complications in total parenteral nutrition (TPN) patients were blood glucose levels both before and within the first 24 hours of TPN, said Dr. Francisco J. Pasquel of Emory University, Atlanta, and his colleagues.
In this study, the researchers reviewed data from 276 consecutive patients at a single hospital. The average age of the patients was 51 years, and 19% had diabetes before entering the hospital. The patients received TPN for an average of 15 days, and most (65%) were surgical patients (Diabetes Care 2009 Dec. 29 [doi: 10.2337/dc09-1748
After the researchers controlled for age, sex, and diabetes history, mortality was significantly associated with a pre-TPN blood glucose level of 121-150 mg/dL, 151-180 mg/dL, or greater than 180 mg/dL. In addition, blood glucose within 24 hours of TPN was a significant predictor of mortality. Compared with patients who did not die, deceased patients had significantly higher blood glucose within 24 hours of TPN (162 mg/dL vs. 139 mg/dL) and during days 2-10 of TPN (161 mg/dL vs. 142 mg/dL).
Patients with blood glucose greater than 180 mg/dL within 24 hours of TPN were more than three times as likely to develop pneumonia and more than twice as likely to develop acute renal failure, compared with patients with blood glucose levels below 120 mg/dL.
In addition, patients with higher blood glucose levels during TPN treatment spent significantly more time in both the ICU and the hospital compared with patients with lower blood glucose levels.
The results suggest that early intervention against hyperglycemia may improve outcomes for TPN patients.
“Our study indicates that blood glucose values prior to and within 24 hours of TPN are better predictors of hospital mortality and complications than the mean blood glucose during the entire duration of TPN,” the researchers said.