Assessment of patterns and associated factors of dysglycemia among critically ill adult Patients admitted to JUMC, Jimma, southwest Ethiopia: A prospective follow-up study

Abstract

Background: Dysglycemia, which includes hyperglycemia, hypoglycemia, and increased glucose variability, is common and independently associated with mortality in critically ill patients and the optimal blood glucose target in these patient population is still uncertain. Limited data exists on the pattern and associated factors of dysglycemia among critically ill adult patients in Ethiopia. Objective: To assess patterns and associated factors of dysglycemia among critically ill adult patients admitted to Jimma University Medical Center. Methods: A prospective follow-up study was conducted on 158 critically ill adult patients admitted to adult medical, surgical and emergency ICUs, and stroke and cardiac units of Jimma University Medical Center between November, 2022 and January, 2023. Patients who fulfil the inclusion criteria were enrolled and had their blood glucose levels checked every 6 hours. Data was entered into EpiData Version 3.2 and analyzed using SPSS software Version 26. Results: Of 158 participants, 51.9% were males, about 50.6% were between the ages of 25-54 years, with a mean age of 45.42 years. The most common comorbidities were hypertension (39.47%) and chronic heart failure (31.57%) and acute stroke (31.6%) was the most frequent diagnosis at admission followed by acute decompensated heart failure (13.3%). Only 8.2% of patients achieved the target blood glucose, and 72.2% were below target.. At least one episode of hyperglycemia and hypoglycemia was observed in 23.4% and 17.7% of patients respectively with a dysglycemia rate of about 41.1% overall. Having comorbidity (p=0.01, AOR=2.23, 95% CI=0.88, 5.90) and chronic kidney disease (p=0.00, AOR=2.20, 95% CI=1.82, 5.92) were associated with hyperglycemia, while sepsis or septic shock at admission (p=0.01, AOR=3.02, 95%CI=2.28,11.22) and acute kidney injury (p=0.02, AOR=8.37,95% CI=4.03-14.76) were associated with hypoglycemia. Conclusion: There was high prevalence of dysglycemia among critically ill patients, with comorbidity and chronic kidney disease being factors associated with hyperglycemia and sepsis or septic shock at admission and acute kidney injury with hypoglycemia. These findings highlight the importance of blood glucose monitoring and management in critically ill patients to improve patient outcomes.