Journal of Diabetes and Metabolic Disorders 2009. 8( ):3-.

Prevalence of Stress Hyperglycemia and Its Related Death Rate in Patients of Emam Reza Hospital Emergency Department of Mashad, Iran
Moosavi Z, Hezarkhani S, Rokni Yazdi H, Ebrahimzadeh S


Background: Stress hyperglycemia is associated with increased mortality in critically ill patients. The aim of this study was to determine the prevalence of stress hyperglycemia and its association with mortality among patients admitted to emergency department.

Methods: As a prospective study in a period of 6 months, 1031 patients admitted to emergency department, were evaluated. At baseline blood sample was taken for BS, urea, creatinine and hematocrit. At least two blood samples for FBS were taken.   Patients with malignancy and those with less than 24 hours admission were excluded. Patients were classified into five groups according to FBS: 1) Stress hyperglycemia: FBS≥126 mg/dl at two times without history of diabetes mellitus; 2) Diabetics; 3) Impaired fasting glucose (110<FBS< 126) on two instances; 4) Glucocorticoid treatment; and 5) Normal. HbA1c was measured at baseline for stress hyperglycemic group.

Results: Eight hundred Sixty six patients (480 male and 386 female) aged 54±18.1 years entered the study. The prevalence of stress hyperglycemia was 14%, Known diabetes 15.6%, IFG was 6.1%, patients on corticosteroid  7% and normal blood glucose 57.3%. Mortality was higher in stress hyperglycemic group (19.8%) compared with diabetics (3.7%), normoglycemic patients (1.4%), IFG patients (1.9%) and patients on glucocorticoid treatment (4.9%) (P=0.0001). Duration of hospitalization was longer in stress hyperglycemia compared with normoglycemic group (P=0.002) but not with other groups. Patients with stress hyperglycemia had higher ICU admission (P=0.001). Eight percent of stress hyperglycemic patients had HbA1c higher than 6%. Mortality and duration of hospital stay in this group was the same as normal HbA1c.

 Conclusion:  Stress hyperglycemia is common among emergency admissions and these patients have significantly higher mortality  rate compared to other patients (P=0.001).



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