Stress Hyperglycemia Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis

Yang, Xinmin, Zhang, Ruwen, Jin, Tao, Zhu, Ping, Yao, Linbo, Li, Lan, Cai, Wenhao ORCID: 0000-0002-4328-3341, Mukherjee, Rajarshi, Du, Dan, Fu, Xianghui
et al (show 11 more authors) (2022) Stress Hyperglycemia Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis. DIGESTIVE DISEASES AND SCIENCES, 67 (5). pp. 1879-1889.

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<h4>Background/aims</h4>Stress hyperglycemia is common in critical illness but it has not been clearly studied in patients with acute pancreatitis (AP). This study aimed to investigate the specific blood glucose (BG) level that defines stress hyperglycemia and to determine the impact of stress hyperglycemia on clinical outcomes in AP patients.<h4>Methods</h4>AP patients admitted ≤ 48 h after abdominal pain onset were retrospectively analyzed. Patients were stratified by pre-existing diabetes and stress hyperglycemia was defined using stratified BG levels for non-diabetes and diabetes with clinical outcomes compared.<h4>Results</h4>There were 967 non-diabetic and 114 diabetic (10.5%) patients met the inclusion criteria and the clinical outcomes between these two groups were not significantly different. In non-diabetes, the cut-off BG level of ≥ 180 mg/dl was selected to define stress hyperglycemia with an 8.8-fold higher odds ratio for persistent organ failure (POF) (95% CI 5.4-14.3; P < 0.001). For diabetes, ≥ 300 mg/dl was selected with a 7.5-fold higher odds ratio for POF (95% CI 1.7-34.3; P = 0.009). In multivariable logistic regression, stress hyperglycemia was independently associated with POF, acute necrotic collection, major infection and mortality. The combination of BG and systemic inflammatory response syndrome (SIRS) score in predicting POF was better than SIRS or Glasgow score alone.<h4>Conclusions</h4>This study identifies a cut-off BG level of ≥ 180 mg/dl and ≥ 300 mg/dl was optimal to define stress hyperglycemia for non-diabetic and diabetic AP patients, respectively. There was a significant relationship between stress hyperglycemia and adverse clinical outcomes.

Item Type: Article
Uncontrolled Keywords: Acute pancreatitis, Blood glucose, Stress hyperglycemia, Diabetes mellitus, Persistent organ failure, Receiver operating characteristic curve
Divisions: Faculty of Health and Life Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 May 2021 10:38
Last Modified: 18 Jan 2023 22:49
DOI: 10.1007/s10620-021-06982-8
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