A Systematic Scoping Review on the Consequences of Stress-related Hyperglycaemia

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 Apr 7

PMID 29624594

Citations 25

Authors

Elena Olariu

Nicholas Pooley

Aurelie Danel

Montserrat Miret

Jean-Charles Preiser

Affiliations

Soon will be listed here.

Abstract

Background: Stress-related hyperglycaemia (SHG) is commonly seen in acutely ill patients and has been associated with poor outcomes in many studies performed in different acute care settings. We aimed to review the available evidence describing the associations between SHG and different outcomes in acutely ill patients admitted to an ICU. Study designs, populations, and outcome measures used in observational studies were analysed.

Methods: We conducted a systematic scoping review of observational studies following the Joanna Briggs methodology. Medline, Embase, and the Cochrane Library were searched for publications between January 2000 and December 2015 that reported on SHG and mortality, infection rate, length of stay, time on ventilation, blood transfusions, renal replacement therapy, or acquired weakness.

Results: The search yielded 3,063 articles, of which 43 articles were included (totalling 536,476 patients). Overall, the identified studies were heterogeneous in study conduct, SHG definition, blood glucose measurements and monitoring, treatment protocol, and outcome reporting. The most frequently reported outcomes were mortality (38 studies), ICU and hospital length of stay (23 and 18 studies, respectively), and duration of mechanical ventilation (13 studies). The majority of these studies (40 studies) compared the reported outcomes in patients who experienced SHG with those who did not. Fourteen studies (35.9%) identified an association between hyperglycaemia and increased mortality (odds ratios ranging from 1.13 to 2.76). Five studies identified hyperglycaemia as an independent risk factor for increased infection rates, and one identified it as an independent predictor of increased ICU length of stay.

Discussion: SHG was consistently associated with poor outcomes. However, the wide divergences in the literature mandate standardisation of measuring and monitoring SHG and the creation of a consensus on SHG definition. A better comparability between practices will improve our knowledge on SHG consequences and management.

Citing Articles

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Accuracy of Freestyle Libre continuous glucose monitoring system in critically ill patients after cardiac surgery.

Gu J, Zhao Z, Li H, Li B, Chen S, Cao Y J Cardiothorac Surg. 2025; 20(1):75.

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Metabolic Disturbances Associated with In-Hospital Complication and Mortality in Different Types of Pneumonia.

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Association and predictive ability between significant perioperative cardiovascular adverse events and stress glucose rise in patients undergoing non-cardiac surgery.

Lin J, Chen Y, Xu M, Chen J, Huang Y, Chen X Cardiovasc Diabetol. 2024; 23(1):445.

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