Diabetes Does Not Influence Selected Clinical Outcomes in Critically Ill Burn Patients

Abstract

Objective Evaluate glucose control and clinical outcomes in diabetic burn ICU patients. Methods We reviewed 462 civilian patients admitted to our burn ICU over four years. Exclusion criteria were age<18, admission because of skin infection, incomplete records, and military patients. Subjects were labeled as diabetic if they had a diagnosis of diabetes documented in their medical records. Otherwise they were labeled as non-diabetic. Diabetics (n=57) were compared to non-diabetics (n=405). Admission glucose levels were obtained from chemistries. Point-of-care devices provided the remaining glucose values. While in the burn ICU hyperglycemia for all patients was treated using intensive insulin therapy with a target blood glucose goal of 80 110mg/dL. Mann-Whitney U, Chi-square, and multivariate regressions were used for statistical analysis (p 0.05). Results Diabetics were older (60 15 vs 44 17years) with higher admission glucose (196 81 vs 133 52mg/dL), mean glucose (147 37 vs 122 24mg/dL), glucose variability (30 11 vs 22 11%), and fewer ICU-free days (18 12 vs 20 11). After multivariate regression analyses age, ISS, TBSA, admission glucose, and mean glucose significantly affected the number of ventilatorfree days, ICU-free days, and hospital-free days. Glucose variability was associated with hospitalfree days only. Age, ISS, and TBSA significantly influenced mortality whereas a pre-existing diagnosis of diabetes was not associated with any clinical outcomes. Conclusions Admission blood glucose is higher and blood glucose is more difficult to control in diabetic burn ICU patients. A pre-existing diagnosis of diabetes does not influence clinical outcomes in critically ill burn patients.

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Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2011
Accession Number
ADA618972

Entities

People

  • Alejandra Mora
  • Chaitanya K. Dahagam
  • Charles E Wade
  • Steven Wolf

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Burns
  • Chemistry
  • Combat Casualty Care
  • Health Services
  • Hospitals
  • Intensive Care Units
  • Medical Personnel
  • Patient Care
  • Point-Of-Care Diagnostic Testing
  • Regression Analysis
  • Sepsis
  • Statistical Analysis
  • Therapy
  • United States

Fields of Study

  • Medicine

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