Dilek YAVUZ GOGAS, Dilek YAZICI, Sevim ÖZCAN, Oğuzhan DEYNELİ, Sema AKALIN, Özlem TARÇIN

Hastanede yatan hastalarda hiperglisemi sıklığı

Amaç: Hiperglisemi hastane mortalite ve morbiditesini etkileyen faktörlerden birisidir. Yatan hastaların yaklaşık yarısında hiperglisemi varlığının ilk kez tespit edildiği rapor edilmiştir. Bu çalışmanın amacı, Marmara Üniversitesi Hastanesi’nde yatan hastalarda yattıkları ve taburcu oldukları dönemlerde hiperglisemi sıklığının ve hipergliseminin yatış süresi ile ilişkisinin belirlenmesidir. Hastalar ve Yöntem: Çalışmaya, Şubat-Temmuz 2007 tarihleri arasında Marmara Üniversitesi Hastanesi kliniklerinde 24 saatten uzun sureli yatan 1971 erişkin hasta dahil edilmiştir. Hastaların yattıkları ve taburcu oldukları günlerde kan şekerleri, kapiller kandan glukometre ile ölçülmüştür. Glukometre ile ölçülen açlık kan şekeri 126 mg/dL veya tokluk kan şekeri 200 mg /dLüzerinde bulunan hastaların damarlarından alınan kan örneklerinde kan şekeri ölçümleri laboratuvarda yapılmıştır. Hastaların diyabet öyküleri ve yatış süreleri kaydedilmiştir. Bulgular: Hastaların %23.8’inde bilinen diyabet (Grup 1), % 12.3’ ünde yeni tanılı diyabet (Grup 2) saptanmıştır. Grup 1 en sık Koroner Yoğun Bakım Ünitesi’nde (%80) ve en seyrek Beyin Cerrahisi Servisi’nde (% 5.8) görülürken, Grup 2’nin sıklığı en yüksek Göz Servisi hastalarında (%25), en düşük ise Fizik Tedavi Servisi hastalarındadır (%2.7). Grup 1’de yatış ve çıkış sırasında kan şekeri değerleri sırası ile cerrahi bölümlerde diyabet olan ve olmayanlarda (157.6 ± 49.0 vs 151.0 ± 60.0, p>0.05) (114.4 ± 37.7 vs 111.8 ± 26.6, p>0.05), dahili bölümlerde diyabet olan (173.9 ± 89.5 vs 155.6 ± 43.4, p>0.05) ve olmayanlarda (110.7 ± 38.3 vs 111.9 ± 28.0, p>0.05) olarak bulunmuştur. Diyabetik hastaların yatış süresi (14.1±19 gün) diyabetik olmayanlara (7.5±13 gün) göre daha uzundur (p<0.001). Sonuç: Hastanede yatan hastalarda hiperglisemi sıklığı %36.1 olup, bunların yaklaşık 1/3’ü yeni tanılı diyabettir. Diyabetik hastaların yatış süresi daha uzundur.

Anahtar Kelimeler:

Hiperglisemi, Diabetes mellitus, Yeni tanılı diabetes mellitus, Hastane yatışı

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Objectives: Hyperglycemia affects mortality and morbidity in hospitalized patients. About half of the cases represent a newonset of hyperglysemia, the aim was to determine the frequency of hyperglycemia in hospitalized patients on the first and last days of their hospital stay and to determine the relationship of hyperglycemia with the length of hospital stay.Patients and Methods: One thousand nine hundred and seventy one patients hospitalized at Marmara University Hospital for longer than 24 hours between February and July 2007 were included. Capillary blood glucose (BG) was measured by glucometers on the first and last days of hospitalizations. If fasting blood glucose levels measured by glucometer were above 126 mg/dL or random blood glucose levels were above 200 mg/dL, then blood samples were taken from the forearm and blood glucose levels were measured in the laboratory. The history of diabetes and the length of hospital stay of patients were recorded.Results: Patients with a diagnosis of diabetes (Group 1) were 23.8% and the new-onset diabetes (Group 2) patients were 12.3% of the total. The frequency of Group 1 patients was highest (80%) for those in the Coronary Care Unit, and lowest (% 5.8) in the Neurosurgery Clinic. The frequency of Group 2 patients was highest (%25) in the Eye Diseases Clinic and lowest (%2.7) in the Physical Therapy and Rehabilitation Clinic. BG on the first and last days of the hospital stay at the surgery clinics respectively were 157.6 ± 49.0 vs 151.0 ± 60.0 (p>0.05) for the diabetic patients, and were 114.4 ± 37.7 vs 111.8 ± 26.6 (p>0.05) for non-diabetic patients. BG on the first and last days of the hospital stay at the nonsurgery clinics respectively was 173.9 ± 89.5 vs 155.6 ± 43.4 (p>0.05) for diabetic patients and were 110.7 ± 38.3 vs 111.9 ± 28.0 (p>0.05) for nondiabetic patients. The length of the hospital stay for Group 1 was longer than for Group 2 (p

Keywords:

Hyperglycemia Diabetes mellitus, New-onset diabetes mellitus, Hospital, Inpatient,

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