Admission hyperglycemia increases mortality in burns

Introduction

Stress hyperglycemia is a common event in acute critical illness. Hyperglycemia may contribute to morbidity and mortality after burns. The purpose of this study was to assess the incidence of admission hyperglycemia in burn patients and its repercussion on mortality rates.

Patients and methods

A survey of the medical records from January 2000 to January 2004 identified 855 patients. Only unknown diabetic patients with admission blood glucose levels >1.4 g/l were considered. The group of hyperglycemia patients (H+) was compared with a control patient group deemed to have normal glucose level and the same epidemiological data (H-). Data analysis was performed with EpiInfo software.

Results

Admission hyperglycemia was observed in 8.6% of patients (74/855 admissions). Only 15 patients had the benefit of insulin therapy. Epidemiological characteristics and gravity scores where similar in the two groups, H+ and H-, as shown in Table 1. The mortality rate in group H+ (46%), however, was significantly higher than in group H- (28.4%), P = 0.04.

Table 1

Conclusion

Admission hyperglycemia was observed in 8.6% of our patients. It is a bad prognosis factor in burn patients. Only an aggressive insulin therapy allowing a strict control of blood glucose level can reduce the mortality rate in this group.