ECE2016 Eposter Presentations Diabetes (to include epidemiology, pathophysiology) (83 abstracts)
Stress hyperglycemia ratio as a marker of disease severity in hospitalized patients with acute pyelonephritis
Francisco Sousa Santos 1 , Margarida Fonseca 2 , Ana Pãosinho 2 , Inês Cruz 2 , João Sequeira Duarte 1 , Clotilde Gouveia 1 , Alberto Mello e Silva 2 & Carlos Vasconcelos 1
1Centro Hospitalar Lisboa Ocidental – Endocrinology, Lisbon, Portugal; 2Centro Hospitalar Lisboa Ocidental – Internal Medicine, Lisbon, Portugal.
Introduction: Hyperglycemia (irrespective of the presence of diabetes) has been associated with worse outcomes in hospitalized patients with a variety of diseases, namely critical illness. It is been recently proposed that a relative hyperglycemia – Stress Hyperglycemia Ratio (SHR) – might be even better associated with disease outcomes. We studied how SHR correlated with various morbidity parameters in hospitalized patients due to acute pyelonephritis.
Methods: We conducted a retrospective study in a Portuguese hospital. We included every patient admitted to Medicine or Endocrinology wards with the main diagnosis of acute pyelonephritis (which had HbA1c measured during the stay) between 2012 and 2015. SHR was calculated as admission glycemia divided by estimated average glucose derived from HbA1c. We assessed the duration of the hospital stay, analytical markers and Systemic Inflamatory Response Syndrome (SIRS) criteria at admission.
Results: A total of 57 patients (71.9% female) were included, with a mean age of 76.7 years old. 77.2% had the diagnosis of Type 2 Diabetes and the remainder were non-diabetic. 45.6% had sepsis criteria and the mean duration of hospital stay was 12.4 days. SHR (but not absolute glycemia) correlated positively with the length of hospital stay (P=0.041) and negatively with estimated glomerular filtrate rate (CKD-EPI formula) (P=0.018) at admission, in a Pearson correlation test. After adjusting for age, sex and diabetes presence, SHR correlated positively with the number of SIRS criteria.
Conclusion: SHR, which takes into account background glycemia rather than absolute glycemia alone, might be a biomarker of disease severity in case of patients hospitalized with acute pyelonephritis irrespective of being diabetic or not. Given this was a retrospective study and sample size was rather small, further studies are needed to confirm this hypothesis and to assess SHR relation with clinical outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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