Update on inpatient glycemic control in hospitals in the United States

Christine Swanson, Daniel Potter, Gail Kongable, Curtiss Cook

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Objective: To provide data on glucose control in hospitals in the United States, analyzing measurements from the largest number of facilities to date. Methods: Point-of-care bedside glucose (POC-BG) test results were extracted from 575 hospitals from January 2009 to December 2009 by using a laboratory information management system. Glycemic control for patients in the intensive care unit (ICU) and non-ICU areas was assessed by calculating patient-day-weighted mean POC-BG values and rates of hypoglycemia and hyperglycemia. The relationship between POC-BG levels and hospital characteristics was determined.Results: A total of 49,191,313 POC-BG measurements (12,176,299 ICU and 37,015,014 non-ICU values) were obtained from 3,484,795 inpatients (653,359 in the ICU and 2,831,436 in non-ICU areas). The mean POC-BG was 167 mg/dL for ICU patients and 166 mg/dL for non-ICU patients. The prevalence of hyperglycemia (>180 mg/dL) was 32.2% of patient-days for ICU patients and 32.0% of patient-days for non-ICU patients. The prevalence of hypoglycemia (<70 mg/dL) was 6.3% of patient-days for ICU patients and 5.7% of patient-days for non-ICU patients. Patient-day-weighted mean POC-BG levels varied on the basis of hospital size (P<.01), type (P<.01), and geographic location (P<.01) for ICU and non-ICU patients, with larger hospitals (≥400 beds), academic hospitals, and US hospitals in the West having the lowest mean POC-BG values. The percentage of patient-days in the ICU characterized by hypoglycemia was highest among larger and academic hospitals (P<.05) and least among hospitals in the Northeast (P<.001). Conclusion: Hyperglycemia is common in hospitals in the United States, and glycemic control may vary on the basis of hospital characteristics. Increased hospital participation in data collection may support a national benchmarking process for the development of optimal practices to manage inpatient hyperglycemia.

Original languageEnglish (US)
Pages (from-to)853-861
Number of pages9
JournalEndocrine Practice
Volume17
Issue number6
DOIs
StatePublished - Nov 1 2011

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Point-of-Care Systems
Inpatients
Intensive Care Units
Glucose
Hyperglycemia
Patient Care
Hypoglycemia
Clinical Laboratory Information Systems
Health Facility Size
Benchmarking
Geographic Locations
Information Management

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Update on inpatient glycemic control in hospitals in the United States. / Swanson, Christine; Potter, Daniel; Kongable, Gail; Cook, Curtiss.

In: Endocrine Practice, Vol. 17, No. 6, 01.11.2011, p. 853-861.

Research output: Contribution to journalArticle

Swanson, C, Potter, D, Kongable, G & Cook, C 2011, 'Update on inpatient glycemic control in hospitals in the United States', Endocrine Practice, vol. 17, no. 6, pp. 853-861. https://doi.org/10.4158/EP11042.OR
Swanson, Christine ; Potter, Daniel ; Kongable, Gail ; Cook, Curtiss. / Update on inpatient glycemic control in hospitals in the United States. In: Endocrine Practice. 2011 ; Vol. 17, No. 6. pp. 853-861.
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