Diabetes Mellitus and its Effect on Outcome in Patients with Acute Respiratory Failure due to COPD Exacerbation

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 818-841-Diabetes Pathophysiology & Complications
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-835
Danae Delivanis*1, Pooja Luthra2, N Burki1 and D Datta1
1University of CT Health Center, Farmington, CT, 2Univ of Conn Hlth Center, Farmington, CT
Background: Acute hyperglycemia is associated with poor outcomes in several acute illnesses including acute exacerbation of COPD. There is minimal literature on the impact of hyperglycemia on acute respiratory failure due to acute COPD exacerbation.  Whether the presence of underlying diabetes mellitus (DM) adversely affects outcome in these patients has not been studied.

Objective: The objective of this study was to determine if the presence of diabetes mellitus in patients with acute respiratory failure due to acute exacerabtion of COPD adversely affects outcome as measured by ICU length of stay (LOS), hospital length of stay (LOS) and occurrence of adverse events such as sepsis and death in this group of patients.

Methods:Medical records of 75 patients admitted to the ICU of our institution with acute COPD exacerbation causing acute respiratory failure were reviewed. Data obtained from records included patient demographics and number of patients with underlying diabetes mellitus. ICU LOS and hospital LOS of patients with and without DM was determined. The incidence of sepsis and death in these two groups of patients was also determined. Univariate logistic regression analysis was performed to evaluate the effect of diabetes on the following outcomes - ICU LOS, hospital LOS, death and sepsis. Paired t-test was performed to determine the difference in these outcomes between diabetic and non-diabetic patients.

Results: Forty (54%) of the patients were females. Mean age was 72.4±11.2 years. Thirty-seven patients (49%) had diabetes. Mean admission blood glucose was 156±73 mg%. Ninety-four percent received ventilatory support and 6% received oxygen via Ventimask. Mean glucose at admission was 175 ± 92 mg% in diabetics and 138 ± 32 mg% in non-diabetics (p= 0.02). ICU LOS was 4±4.6 days in diabetics and 2.8±2 days in non-diabetics (p=0.26). Hospital LOS was 10±7 days in diabetics and 7±3 days in non-diabetics (p=0.01). Sepsis was seen in 16 (47%) diabetic patients and 6 (15%) non-diabetics (p= 0.005). Death occurred in 1of the diabetic group and in 3 of the non-diabetic group (p=0.32)

Conclusions: Diabetic patients with COPD who are admitted with acute respiratory failure due to acute exacerbation of COPD have a higher incidence of sepsis and a longer hospital LOS. Prospective studies are needed to confirm these findings and determine if tighter glycemic control improves these outcomes in this group of patients.

Nothing to Disclose: DD, PL, NB, DD

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm