THE EFFECT OF POOR GLYCEMIC CONTROL ON INTENSIVE CARE UNIT MORTALITY AND CLINICAL OUTCOMES IN CRITICALLY ILL PATIENTS IN SELECTED TERTIARY HOSPITALS; ADDIS ABABA, ETHIOPIA

Abstract

Abstract Background: Poor glycemic control is frequently encountered in the ICU and it includes hyperglycemia, hypoglycemia and glycemic variability which are associated with increased rate of mortality and morbidity. Hyperglycemia is the most frequent among the components of poor glycemic control and its prevalence is 40-90%. The prevalence and outcome of poor glycemic control has not been described in Ethiopia. Objectives: The aim of the study is to describe the effect of poor glycemic control on intensive care unit mortality and clinical outcomes in selected tertiary hospitals. Methods: An institution based cross-sectional study was conducted by using systematic random sampling. Data was collected from patient cards and was entered using Epi Info 7.2. Data analysis was done using SPSS 27.0. Descriptive statistics was used to summarize the data. Associations between variables were measured with chi square and Mann Whitney U test. Multivariable logistic regression was used to identify predictors of mortality and test the association of poor glycemic control and mortality. Odds ratios with 95% confidence intervals were calculated, and a p-value <0.05 was considered to declare significance Result: The study included 392 patient records, with a median age of 38 years [IQR 28 – 56]. About 53% of patients were females. The prevalence of hyperglycemia, hypoglycemia and high glycemic variability was 90.3%, 16.3% and 19.4% respectively. Hypoglycemia was significantly associated with mortality (AOR 2.98, p < .05). Patients with hyperglycemia and hypoglycemia had significantly longer lengths of stay and durations of mechanical ventilation. High glycemic variability was not significantly associated with mortality, length of stay or duration of mechanical ventilation. Conclusion: Poor glycemic control is very prevalent among patients admitted in the ICU and hypoglycemia may be associated with ICU mortality and adverse clinical outcomes Key words: Critical illness, Poor glycemic control, Stress hyperglycemia, Hypoglycemia, Glycemic variability, Mortality