Diabetes does not influence selected clinical outcomes in critically ill burn patients

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

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The purpose of this study was to evaluate glucose control and clinical outcomes in diabetic burn intensive care unit (ICU) patients. The authors reviewed 462 civilian patients admitted to the burn ICU over 4 years. Exclusion criteria were age <18 years, 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 nondiabetic. Diabetic patients (n = 57) were compared with nondiabetic patients (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 level of 80 to 110 mg/dl. Mann-Whitney U test, χ test, and multivariate regressions were used for statistical analysis (P ≤.05). Diabetic patients were older (60 ± 15 vs 44 ± 17 years) with higher admission glucose (196 ± 81 vs 133 ± 52 mg/dl), mean glucose (147 ± 37 vs 122 ± 24 mg/dl), glucose variability (30 ± 11 vs 22 ± 11%), and fewer ICU-free days (18 ± 12 vs 20 ± 11). After multivariate regression analyses, age, injury severity score, TBSA, admission glucose, and mean glucose significantly affected the number of ventilator-free days, ICU-free days, and hospital-free days. Glucose variability was associated with hospital-free days only. Age, injury severity score, and TBSA significantly influenced mortality, whereas a preexisting diagnosis of diabetes was not associated with any clinical outcomes. Admission blood glucose is higher, and blood glucose is more difficult to control in diabetic burn ICU patients. A preexisting diagnosis of diabetes does not influence clinical outcomes in critically ill burn patients.

Original languageEnglish (US)
Pages (from-to)256-262
Number of pages7
JournalJournal of Burn Care and Research
Volume32
Issue number2
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

Fingerprint

Critical Illness
Glucose
Intensive Care Units
Blood Glucose
Injury Severity Score
Point-of-Care Systems
Mechanical Ventilators
Nonparametric Statistics
Hyperglycemia
Medical Records
Multivariate Analysis
Regression Analysis
Insulin
Equipment and Supplies
Skin
Mortality
Infection

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Diabetes does not influence selected clinical outcomes in critically ill burn patients. / Dahagam, Chaitanya K.; Mora, Alejandra; Wolf, Steven; Wade, Charles E.

In: Journal of Burn Care and Research, Vol. 32, No. 2, 01.03.2011, p. 256-262.

Research output: Contribution to journalArticle

Dahagam, Chaitanya K. ; Mora, Alejandra ; Wolf, Steven ; Wade, Charles E. / Diabetes does not influence selected clinical outcomes in critically ill burn patients. In: Journal of Burn Care and Research. 2011 ; Vol. 32, No. 2. pp. 256-262.
@article{67ba70a455b548878266647682145be7,
title = "Diabetes does not influence selected clinical outcomes in critically ill burn patients",
abstract = "The purpose of this study was to evaluate glucose control and clinical outcomes in diabetic burn intensive care unit (ICU) patients. The authors reviewed 462 civilian patients admitted to the burn ICU over 4 years. Exclusion criteria were age <18 years, 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 nondiabetic. Diabetic patients (n = 57) were compared with nondiabetic patients (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 level of 80 to 110 mg/dl. Mann-Whitney U test, χ test, and multivariate regressions were used for statistical analysis (P ≤.05). Diabetic patients were older (60 ± 15 vs 44 ± 17 years) with higher admission glucose (196 ± 81 vs 133 ± 52 mg/dl), mean glucose (147 ± 37 vs 122 ± 24 mg/dl), glucose variability (30 ± 11 vs 22 ± 11{\%}), and fewer ICU-free days (18 ± 12 vs 20 ± 11). After multivariate regression analyses, age, injury severity score, TBSA, admission glucose, and mean glucose significantly affected the number of ventilator-free days, ICU-free days, and hospital-free days. Glucose variability was associated with hospital-free days only. Age, injury severity score, and TBSA significantly influenced mortality, whereas a preexisting diagnosis of diabetes was not associated with any clinical outcomes. Admission blood glucose is higher, and blood glucose is more difficult to control in diabetic burn ICU patients. A preexisting diagnosis of diabetes does not influence clinical outcomes in critically ill burn patients.",
author = "Dahagam, {Chaitanya K.} and Alejandra Mora and Steven Wolf and Wade, {Charles E.}",
year = "2011",
month = "3",
day = "1",
doi = "10.1097/BCR.0b013e31820aaf68",
language = "English (US)",
volume = "32",
pages = "256--262",
journal = "Journal of Burn Care and Research",
issn = "1559-047X",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Diabetes does not influence selected clinical outcomes in critically ill burn patients

AU - Dahagam, Chaitanya K.

AU - Mora, Alejandra

AU - Wolf, Steven

AU - Wade, Charles E.

PY - 2011/3/1

Y1 - 2011/3/1

N2 - The purpose of this study was to evaluate glucose control and clinical outcomes in diabetic burn intensive care unit (ICU) patients. The authors reviewed 462 civilian patients admitted to the burn ICU over 4 years. Exclusion criteria were age <18 years, 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 nondiabetic. Diabetic patients (n = 57) were compared with nondiabetic patients (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 level of 80 to 110 mg/dl. Mann-Whitney U test, χ test, and multivariate regressions were used for statistical analysis (P ≤.05). Diabetic patients were older (60 ± 15 vs 44 ± 17 years) with higher admission glucose (196 ± 81 vs 133 ± 52 mg/dl), mean glucose (147 ± 37 vs 122 ± 24 mg/dl), glucose variability (30 ± 11 vs 22 ± 11%), and fewer ICU-free days (18 ± 12 vs 20 ± 11). After multivariate regression analyses, age, injury severity score, TBSA, admission glucose, and mean glucose significantly affected the number of ventilator-free days, ICU-free days, and hospital-free days. Glucose variability was associated with hospital-free days only. Age, injury severity score, and TBSA significantly influenced mortality, whereas a preexisting diagnosis of diabetes was not associated with any clinical outcomes. Admission blood glucose is higher, and blood glucose is more difficult to control in diabetic burn ICU patients. A preexisting diagnosis of diabetes does not influence clinical outcomes in critically ill burn patients.

AB - The purpose of this study was to evaluate glucose control and clinical outcomes in diabetic burn intensive care unit (ICU) patients. The authors reviewed 462 civilian patients admitted to the burn ICU over 4 years. Exclusion criteria were age <18 years, 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 nondiabetic. Diabetic patients (n = 57) were compared with nondiabetic patients (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 level of 80 to 110 mg/dl. Mann-Whitney U test, χ test, and multivariate regressions were used for statistical analysis (P ≤.05). Diabetic patients were older (60 ± 15 vs 44 ± 17 years) with higher admission glucose (196 ± 81 vs 133 ± 52 mg/dl), mean glucose (147 ± 37 vs 122 ± 24 mg/dl), glucose variability (30 ± 11 vs 22 ± 11%), and fewer ICU-free days (18 ± 12 vs 20 ± 11). After multivariate regression analyses, age, injury severity score, TBSA, admission glucose, and mean glucose significantly affected the number of ventilator-free days, ICU-free days, and hospital-free days. Glucose variability was associated with hospital-free days only. Age, injury severity score, and TBSA significantly influenced mortality, whereas a preexisting diagnosis of diabetes was not associated with any clinical outcomes. Admission blood glucose is higher, and blood glucose is more difficult to control in diabetic burn ICU patients. A preexisting diagnosis of diabetes does not influence clinical outcomes in critically ill burn patients.

UR - http://www.scopus.com/inward/record.url?scp=79952441279&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952441279&partnerID=8YFLogxK

U2 - 10.1097/BCR.0b013e31820aaf68

DO - 10.1097/BCR.0b013e31820aaf68

M3 - Article

C2 - 21228710

AN - SCOPUS:79952441279

VL - 32

SP - 256

EP - 262

JO - Journal of Burn Care and Research

JF - Journal of Burn Care and Research

SN - 1559-047X

IS - 2

ER -