دوره 12، شماره 1 - ( 11-1404 )
جلد 12 شماره 1 صفحات 98-87 |
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Menezes Silveira L, Costa Silva S, Lenhari M, Pinto de Melo T, Ruffino-Netto A, Stabile A M. The Influence of Diabetes on Outcomes of Patients With Sepsis. JCCNC 2026; 12 (1) :87-98
URL: http://jccnc.iums.ac.ir/article-1-821-fa.html
URL: http://jccnc.iums.ac.ir/article-1-821-fa.html
The Influence of Diabetes on Outcomes of Patients With Sepsis. نشریه مراقبت پرستاری مددجو محور. 1404; 12 (1) :87-98
چکیده: (264 مشاهده)
Background: Sepsis is characterized by a set of physiological reactions that occur in an unregulated manner in response to an infection. Type 2 diabetes mellitus (T2DM) is a common comorbidity of patients with sepsis. This study compared the clinical outcomes and nursing workload of patients with sepsis with and without T2DM, and investigated their admission characteristics, clinical progression, and blood glucose levels.
Methods: This retrospective cohort study reviewed medical records of adult intensive care patients at a high-complexity, public, tertiary hospital in São Paulo, Brazil. From 2015 to 2019, two groups of 102 patients (with and without T2DM) were consecutively included. Data collected encompassed sociodemographic, clinical admission data (including prognostic scores like sequential organ failure assessment [SOFA], simplified acute physiology score III [SAPS III], and acute physiology and chronic health evaluation II [APACHE II]), ICU progression, patients’ outcomes (e.g. ICU discharge or death), blood glucose levels, and glycemic variability (GV). Nursing workload was assessed by the nursing activity score (NAS). Statistical analysis was performed using the student t-test or the Mann-Whitney test for numerical variables, and the Pearson chi-square test or Fisher exact test for categorical variables in SPSS software, versioon 25. The level of statistical significance adopted was P<0.05.
Results: T2DM patients showed higher mortality (P=0.012), elevated prognostic scores (APACHE II, P=0.035; SAPS III, P=0.033), and greater GV (P<0.001 for all related metrics) compared to non-T2DM patients. While NAS was similar between groups (P=0.644), it was associated with death in both (P=0.000 and P=0.007, respectively).
Conclusion: T2DM significantly influences both ICU and hospital outcomes, leading to higher mortality rates in sepsis patients. The T2DM group presented with more severe admission conditions (as indicated by higher APACHE II and SAPS III scores and a greater number of comorbidities). It exhibited higher average blood glucose and greater GV. While overall NAS was similar, a higher NAS was consistently associated with mortality, highlighting heightened care demands for critically ill patients who progress to death.
Methods: This retrospective cohort study reviewed medical records of adult intensive care patients at a high-complexity, public, tertiary hospital in São Paulo, Brazil. From 2015 to 2019, two groups of 102 patients (with and without T2DM) were consecutively included. Data collected encompassed sociodemographic, clinical admission data (including prognostic scores like sequential organ failure assessment [SOFA], simplified acute physiology score III [SAPS III], and acute physiology and chronic health evaluation II [APACHE II]), ICU progression, patients’ outcomes (e.g. ICU discharge or death), blood glucose levels, and glycemic variability (GV). Nursing workload was assessed by the nursing activity score (NAS). Statistical analysis was performed using the student t-test or the Mann-Whitney test for numerical variables, and the Pearson chi-square test or Fisher exact test for categorical variables in SPSS software, versioon 25. The level of statistical significance adopted was P<0.05.
Results: T2DM patients showed higher mortality (P=0.012), elevated prognostic scores (APACHE II, P=0.035; SAPS III, P=0.033), and greater GV (P<0.001 for all related metrics) compared to non-T2DM patients. While NAS was similar between groups (P=0.644), it was associated with death in both (P=0.000 and P=0.007, respectively).
Conclusion: T2DM significantly influences both ICU and hospital outcomes, leading to higher mortality rates in sepsis patients. The T2DM group presented with more severe admission conditions (as indicated by higher APACHE II and SAPS III scores and a greater number of comorbidities). It exhibited higher average blood glucose and greater GV. While overall NAS was similar, a higher NAS was consistently associated with mortality, highlighting heightened care demands for critically ill patients who progress to death.
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