Cook Curtiss B, Moghissi Etie, Joshi Renu, Kongable Gail L, Abad Victor J
Mayo Clinic College of Medicine, Scottsdale, Arizona, USA.
Diabetes Technol Ther. 2007 Dec;9(6):493-500. doi: 10.1089/dia.2007.0232.
Point-of-care (POC) bedside glucose (BG) testing and timely evaluation of its effectiveness are important components of hospital inpatient glycemic control programs. We describe a new technology to evaluate inpatient POC-BG testing and report preliminary results of inpatient glycemic control from 10 U.S. hospitals.
We used the Remote Automated Laboratory System RALS-Tight Glycemic Control Module (TGCM) (Medical Automation Systems, Charlottesville, VA) connected to the RALS-Plus to extract and analyze inpatient POC-BG tests from 10 U.S. hospitals for a 3-month period. POC-BG measurements were evaluated in aggregate from all 10 facilities for intensive care unit (ICU), non-ICU, and ICU + non-ICU combined.
A total of 742,154 POC-BGs were analyzed. The combined (ICU + non-ICU) mean POC-BG was 159 mg/dL, compared with 146 mg/dL for the ICU and 164 mg/dL for non-ICU. The proportion of hypoglycemic values (<70 mg/dL) was low at 4%, but the percentage of measurements that would be considered hyperglycemic (>180 mg/dL) was high, with more than 30% of values in the non-ICU and 20% in the ICU being elevated.
POC-BG data can be captured through automated data management software and can support hospital efforts to evaluate and monitor the status of inpatient glycemic control. These preliminary data suggest that there is a need to conduct broad-based efforts to improve inpatient glucose management. Increasing hospital participation in data collection has the potential to create a national benchmarking process for the development of best practices and improved inpatient hyperglycemia management.
即时检验（POC）床边血糖（BG）检测及其有效性的及时评估是医院住院患者血糖控制方案的重要组成部分。我们描述了一种新技术，用于评估住院患者的POC - BG检测，并报告来自美国10家医院的住院患者血糖控制初步结果。
我们使用与RALS - Plus相连的远程自动化实验室系统RALS - 严格血糖控制模块（TGCM）（医疗自动化系统公司，弗吉尼亚州夏洛茨维尔），在3个月内从美国10家医院提取并分析住院患者的POC - BG检测数据。对所有10家机构的重症监护病房（ICU）、非ICU以及ICU与非ICU合并后的POC - BG测量值进行汇总评估。
共分析了742,154次POC - BG检测。ICU与非ICU合并后的POC - BG平均水平为159 mg/dL，其中ICU为146 mg/dL，非ICU为164 mg/dL。低血糖值（<70 mg/dL）的比例较低，为4%，但被认为是高血糖（>180 mg/dL）的测量值百分比很高，非ICU中超过30%的测量值升高，ICU中为20%。
POC - BG数据可通过自动化数据管理软件获取，并可支持医院评估和监测住院患者血糖控制状况的工作。这些初步数据表明，有必要开展广泛的工作来改善住院患者的血糖管理。增加医院对数据收集的参与度有可能创建一个全国性的基准流程，以制定最佳实践并改善住院患者高血糖管理。
