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首页> 外文期刊>Journal of Pharmacy and Pharmaceutical Sciences >Evaluation of the Impact of an Inpatient Hyperglycemia Protocol on Glycemic Control
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Evaluation of the Impact of an Inpatient Hyperglycemia Protocol on Glycemic Control

机译：评价住院高血糖方案对血糖控制的影响

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Abstract Purpose: Inpatient hyperglycemia is associated with poor outcomes. Existing research assessing inpatient hyperglycemia protocols has shown improvements in average blood glucose levels with inconsistent results regarding rates of hypoglycemia and hyperglycemia. The objective of this study was to evaluate the impact of an inpatient hyperglycemia protocol on glycemic control. Methods: This retrospective cohort study at a large, community teaching hospital included adult patients in non-critical care units requiring insulin administration for glycemic control. The intervention examined was utilization of an inpatient hyperglycemia protocol, comprised of a computerized physician order entry order set and provider education at the time of implementation. Two cohorts, a pre-protocol implementation group and a post-protocol implementation group, were compared. The primary outcome was the incidence of blood glucose values within 70-180 mg/dL over a 72-hour period between groups. Key secondary outcomes included the incidence of hypoglycemia (less than 70 mg/dL), severe hyperglycemia (above 300 mg/dL), total insulin use, and hospital length of stay. Results: The primary outcome was significantly improved following protocol implementation (54.2% vs. 58.4%, p = 0.001). Compared to the pre-protocol group, the post-protocol group had lower incidence of hypoglycemia (3.1% vs. 1.2%, p 0.001), severe hyperglycemia (9.9% vs. 6.7%, p 0.001), less total insulin use (1.1 units/kg vs. 0.6 units/kg, p 0.001), and shorter length of stay (5.1 days vs. 3.7 days, p 0.001). Conclusions: The implementation of an inpatient hyperglycemia protocol was associated with improved glycemic control, decreased incidence of both hypoglycemia and severe hyperglycemia, and less total insulin use.
机译：摘要目的：住院患者高血糖与不良预后相关。评估住院患者高血糖方案的现有研究表明，平均血糖水平有所改善，但有关低血糖和高血糖发生率的结果却不一致。这项研究的目的是评估住院高血糖方案对血糖控制的影响。方法：这项回顾性队列研究是在一家大型社区教学医院中进行的，研究对象包括需要胰岛素注射以控制血糖的非重症监护病房的成年患者。所检查的干预措施是利用住院患者的高血糖方案，该方案由计算机化的医生订单输入订单集和实施时的提供者教育组成。比较了两个队列，即协议前实施组和协议后实施组。主要结局是两组之间72小时内血糖值在70-180 mg / dL之内的发生率。主要的次要结局包括低血糖的发生率（低于70 mg / dL），严重的高血糖（超过300 mg / dL），胰岛素的使用总量以及住院时间。结果：实施方案后，主要结局明显改善（54.2％vs. 58.4％，p = 0.001）。与协议前组相比，协议后组低血糖发生率较低（3.1％vs. 1.2％，p <0.001），严重高血糖症（9.9％vs. 6.7％，p <0.001），总胰岛素使用量较少（1.1单位/公斤vs. 0.6单位/ kg，p <0.001）和较短的住院时间（5.1天与3.7天，p <0.001）。结论：实施住院高血糖方案与改善血糖控制，降低低血糖症和严重高血糖症的发生率以及减少总胰岛素使用量有关。

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