Plasma glucose levels and mortality in bacteremic ICU patients

Introduction

The influence of the plasma glucose levels on the prognosis of infection is unclear. The aim of this clinical trial is to study the impact of the plasma glucose levels at the onset of bacteremia (PGLOB) on the prognosis of bacteremia in ICU patients.

Methods

We studied retrospectively 202 bacteremic ICU patients (143 men, 59 women). Mean age: 49.3 ± 16.9 years. Mean stay: 25.2 ± 11.1 days. Underlying diseases: multiple trauma 131, complicated surgery 52, other 19. All were mechanically ventilated and developed a nosocomial infection (NI) with at least one positive blood culture. From 202 patients, 34 (16.8%) were diabetic. The PGLOB (at the exact moment of the first positive blood culture) was measured and was related to prognosis of NI.

Results

In diabetic patients the mean PGLOB was 244.5 ± 103.4 mg%, while in nondiabetic patients it was 141.3 ± 58.4 mg%. Global mortality rates (MR): 48/202 = 23.8%. From 48 patients who died, in 37 death was associated with NI with bacteremia; they had mean PGLOB 158.3 ± 91.1 mg%. The other 11 nonsurvivors had 153.4 ± 74.3 mg%. The related MR to NI and bacteremia according to PGLOB were: <75 mg%, MR 33.3%; 75–140 mg%, MR 20.1%; 141–200 mg%, MR 24.5%; >200 mg%, MR 27.1% (P = 0.32).

Conclusion

There was no significant relationship between PGLOB and mortality attributed to NI and bacteremia. Multiple organ dysfunction syndrome was observed more frequently in patients with PGLOB >200 mg%, but not significantly. MR was similar in both diabetic and nondiabetic patients.