Article Sidebar
Views PDF: 94
GLYCATED HEMOGLOBIN (HBA1C) AND RISK OF VENTILATOR ASSOCIATED RESPIRATORY INFECTION (VARI)
Main Article Content
Abstract
Background: VARIs are common hospital acquired infections (HAIs) in intensive care units (ICUs) with worrisome clinical outcomes. Studies about association between diabetes and VARI is scarce and controversial. However, diabetes was mostly diagnosed by patients’ medical histories which could cause isclassification errors.
Subjectives: The aim of this study was to compare the clinical characteristics of individuals with different levels of HbA1c and to investigate the association between HbA1c and the risk of developing VARI in ICU population.
Methods: 562 adult patients intubated for ≤ 24h at the time of enrolment were divided by their HbA1c on admission into 3 categories (< 5.7%, 5.7 - 6.4%, ≥ 6.5%). VARI episodes were recorded up to 90 days after randomization.
Results: ICU stay until the appearance of the first VARI episode between the 3 groups of patients was not statistically significant (P = 0.0603). The risk of developing VARIs was not different in patients with HbA1c between 5.7% - 6.4% (ảnh hưởng R= 0.88 [0.58 - 1.34], p = 0.552) and ≥ 6.5% (aHR 0.88 [0.5 - 1.56], p = 0.663) as compared to those with HbA1c < 5.7%. Conclusion: We found no association between HbA1c and VARI.
Article Details
Keywords
Nhiễm khuẩn hô hấp liên quan đến thở máy, HbA1c, đái tháo đường, khoa hồi sức tích cực
References
2. Bonell A, Azarrafiy R, Huong VTL, et al. A Systematic Review and Meta-analysis of Ventilator-associated Pneumonia in Adults in Asia: An Analysis of National Income Level on Incidence and Etiology. Clin Infect Dis Off Publ Infect Dis Soc Am. 2019;68(3):511. doi:10.1093/cid/ciy543.
3. Rosenthal VD, Udwadia FE, Muñoz HJ, et al. Time-dependent analysis of extra length of stay and mortality due to ventilator-associated pneumonia in intensive-care units of ten limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC). Epidemiol Infect. 2011;139(11):1757-1763. doi:10.1017/S0950268811000094.
4. Kollef MH, Hamilton CW, Ernst FR. Economic Impact of Ventilator-Associated Pneumonia in a Large Matched Cohort. Infect Control Hosp Epidemiol. 2012;33(3):250-256. doi:10.1086/664049.
5. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab. 2012;16(Suppl1):S27-S36. doi:10.4103/2230-8210.94253.
6. Lopez-de-Andres A, Albaladejo-Vicente R, de Miguel-Diez J, et al. Incidence and outcomes of
hospitalization for community-acquired, ventilator-associated and non-ventilator hospital-acquired pneumonias in patients with type 2 diabetes mellitus in Spain. BMJ Open Diabetes Res Care. 2020;8(1). doi:10.1136/bmjdrc-2020-001447.
7. Vardakas KZ, Siempos II, Falagas ME. Diabetes mellitus as a risk factor for nosocomial pneumonia and associated mortality. Diabet Med. 2007;24(10):1168-1171. doi:10.1111/j.1464-5491.2007.02234.x
8. Corstjens AM, van der Horst IC, Zijlstra JG, et al. Hyperglycaemia in critically ill patients: marker or mediator of mortality? Crit Care. 2006;10(3):216. doi:10.1186/cc4957.
9. Craven DE, Hudcova J, Lei Y, Craven KA, Waqas A. Pre-emptive antibiotic therapy to reduce ventilatorassociated pneumonia: “thinking outside the box.” Crit Care. 2016;20(1):300. doi:10.1186/s13054-016-1472-5.
10. Klompas M, Berra L. Should Ventilator-Associated Events become a Quality Indicator for ICUs? Respir Care. 2016;61(6):723-736. doi:10.4187/respcare.04548.