Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients
Objective. To evaluate whether diabetes mellitus (DM) and hemoglobin A1c (HbA1c) are risk factors for ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) in critically ill patients. Methods. Prospective observational study; patients were recruited from the intensive care unit (ICU...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/279479 |
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| author | Eirini Tsakiridou Demosthenes Makris Vasiliki Chatzipantazi Odysseas Vlachos Grigorios Xidopoulos Olympia Charalampidou Georgios Moraitis Epameinondas Zakynthinos |
| author_facet | Eirini Tsakiridou Demosthenes Makris Vasiliki Chatzipantazi Odysseas Vlachos Grigorios Xidopoulos Olympia Charalampidou Georgios Moraitis Epameinondas Zakynthinos |
| author_sort | Eirini Tsakiridou |
| collection | DOAJ |
| description | Objective. To evaluate whether diabetes mellitus (DM) and hemoglobin A1c (HbA1c) are risk factors for ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) in critically ill patients. Methods. Prospective observational study; patients were recruited from the intensive care unit (ICU) of a general district hospital between 2010 and 2012. Inclusion criteria: ICU hospitalization >72 hours and mechanical ventilation >48 hours. HbA1c was calculated for all participants. DM, HbA1c, and other clinical and laboratory parameters were assessed as risk factors for VAP or BSI in ICU. Results. The overall ICU incidence of VAP and BSI was 26% and 30%, respectively. Enteral feeding OR (95%CI) 6.20 (1.91–20.17; P=0.002) and blood transfusion 3.33 (1.23–9.02; P=0.018) were independent risk factors for VAP. BSI in ICU (P=0.044) and ICU mortality (P=0.038) were significantly increased in diabetics. Independent risk factors for BSI in ICU included BSI on admission 2.45 (1.14–5.29; P=0.022) and stroke on admission2.77 (1.12–6.88; P=0.029). Sepsis 3.34 (1.47–7.58; P=0.004) and parenteral feeding 6.29 (1.59–24.83; P=0.009) were independently associated with ICU mortality. HbA1c ≥ 8.1% presented a significant diagnostic performance in diagnosing repeated BSI in ICU. Conclusion. DM and HbA1c were not associated with increased VAP or BSI frequency. HbA1c was associated with repeated BSI episodes in the ICU. |
| format | Article |
| id | doaj-art-e475b79b12e342edba086630483a4759 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-e475b79b12e342edba086630483a47592025-02-03T01:02:25ZengWileyCritical Care Research and Practice2090-13052090-13132013-01-01201310.1155/2013/279479279479Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill PatientsEirini Tsakiridou0Demosthenes Makris1Vasiliki Chatzipantazi2Odysseas Vlachos3Grigorios Xidopoulos4Olympia Charalampidou5Georgios Moraitis6Epameinondas Zakynthinos7Department of Critical Care Medicine, University Hospital of Larissa, University of Thessaly School of Medicine, Biopolis, GR41000 Larisa, GreeceDepartment of Critical Care Medicine, University Hospital of Larissa, University of Thessaly School of Medicine, Biopolis, GR41000 Larisa, GreeceDepartment of Critical Care Medicine, General Hospital of Serres, GR62100 Serres, GreeceDepartment of Critical Care Medicine, General Hospital of Serres, GR62100 Serres, GreeceDepartment of Critical Care Medicine, General Hospital of Serres, GR62100 Serres, GreeceDepartment of Critical Care Medicine, General Hospital of Serres, GR62100 Serres, GreeceDepartment of Hematology Laboratory, General Hospital of Serres, GR62100 Serres, GreeceDepartment of Critical Care Medicine, University Hospital of Larissa, University of Thessaly School of Medicine, Biopolis, GR41000 Larisa, GreeceObjective. To evaluate whether diabetes mellitus (DM) and hemoglobin A1c (HbA1c) are risk factors for ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) in critically ill patients. Methods. Prospective observational study; patients were recruited from the intensive care unit (ICU) of a general district hospital between 2010 and 2012. Inclusion criteria: ICU hospitalization >72 hours and mechanical ventilation >48 hours. HbA1c was calculated for all participants. DM, HbA1c, and other clinical and laboratory parameters were assessed as risk factors for VAP or BSI in ICU. Results. The overall ICU incidence of VAP and BSI was 26% and 30%, respectively. Enteral feeding OR (95%CI) 6.20 (1.91–20.17; P=0.002) and blood transfusion 3.33 (1.23–9.02; P=0.018) were independent risk factors for VAP. BSI in ICU (P=0.044) and ICU mortality (P=0.038) were significantly increased in diabetics. Independent risk factors for BSI in ICU included BSI on admission 2.45 (1.14–5.29; P=0.022) and stroke on admission2.77 (1.12–6.88; P=0.029). Sepsis 3.34 (1.47–7.58; P=0.004) and parenteral feeding 6.29 (1.59–24.83; P=0.009) were independently associated with ICU mortality. HbA1c ≥ 8.1% presented a significant diagnostic performance in diagnosing repeated BSI in ICU. Conclusion. DM and HbA1c were not associated with increased VAP or BSI frequency. HbA1c was associated with repeated BSI episodes in the ICU.http://dx.doi.org/10.1155/2013/279479 |
| spellingShingle | Eirini Tsakiridou Demosthenes Makris Vasiliki Chatzipantazi Odysseas Vlachos Grigorios Xidopoulos Olympia Charalampidou Georgios Moraitis Epameinondas Zakynthinos Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients Critical Care Research and Practice |
| title | Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients |
| title_full | Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients |
| title_fullStr | Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients |
| title_full_unstemmed | Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients |
| title_short | Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients |
| title_sort | diabetes and hemoglobin a1c as risk factors for nosocomial infections in critically ill patients |
| url | http://dx.doi.org/10.1155/2013/279479 |
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