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Learning Objective 1: Identify the incidence of hyperglycemia in hospitalized patients with acute myeloid leukemia.
Learning Objective 2: Describe the impact of hyperglycemia on clinical outcomes of patients with acute myeloid leukemia.
BACKGROUND
Hyperglycemia in hospitalized patients is a concern for individuals with and without diabetes. The link between hyperglycemia and poor clinical outcomes has been well documented in the critically ill patient population. However, to date, few studies have examined the role hyperglycemia in hospitalized leukemia patient.
PURPOSE
The purpose of this study was to compare clinical outcomes in hospitalized leukemia patients with hyperglycemia to those with normoglycemia.
THEORETICAL/SCIENTIFIC FRAMEWORK
The Malglycemia Orbit Model was used to guide this study.
METHODS
A cohort of 42 consecutive leukemia patients admitted for chemotherapy or symptom management between October, 2009, and February, 2011 were reviewed retrospectively. Fasting blood glucose levels were used and hyperglycemia was defined as a blood glucose ≥ 126 mg/dL. Primary outcomes included length of stay, number of neutropenic days and documented infection. Descriptive statistics and t-tests were used to analyze the data.
RESULTS
For the entire sample, 25 of the 42 (60%) leukemia patients were identified as hyperglycemic; 19 of 42 (45%) had a documented infection and the average hospital length of stay for was 13.8 (SD=14.1) days. Leukemia patients with hyperglycemia had significantly longer length of stay (19.6 days versus 5.2 days; p=0.02) and more neutropenic days (11 days versus .4 days; p<0.000) than patients with normoglycemia. There was no difference in diagnosis of infection between the two groups.
CONCLUSIONS
Hyperglycemia was found to be prevalent in this sample of hospitalized leukemia patients. Leukemia patients with hyperglycemia had poorer outcomes including longer length of stay in the hospital and more neutropenic days. These findings suggest that managing blood glucose levels to avoid hyperglycemia could improve outcomes for leukemia patients. More research in this is needed to better understand the impact hyperglycemia has on outcomes of hospitalized leukemia patients.