Anderson Marcy, Zito Denise, Kongable Gail
Medical Automation Systems, Charlottesville, Virginia 2290, USA.
J Diabetes Sci Technol. 2010 Nov 1;4(6):1507-13. doi: 10.1177/193229681000400627.
Hyperglycemia in the adult inpatient population remains a topic of intense study in U.S. hospitals. Most hospitals have established glycemic control programs but are unable to determine their impact. The 2009 Remote Automated Laboratory System (RALS) Report provides trends in glycemic control over 4 years to 576 U.S. hospitals to support their effort to manage inpatient hyperglycemia.
A proprietary software application feeds de-identified patient point-of-care blood glucose (POC-BG) data from the Medical Automation Systems RALS-Plus data management system to a central server. Analyses include the number of tests and the mean and median BG results for intensive care unit (ICU), non-ICU, and each hospital compared to the aggregate of the other hospitals.
More than 175 million BG results were extracted from 2006-2009; 25% were from the ICU. Mean range of BG results for all inpatients in 2006, 2007, 2008, and 2009 was 142.2-201.9, 145.6-201.2, 140.6-205.7, and 140.7-202.4 mg/dl, respectively. The range for ICU patients was 128-226.5, 119.5-219.8, 121.6-226.0, and 121.1-217 mg/dl, respectively. The range for non-ICU patients was 143.4-195.5, 148.6-199.8, 145.2-201.9, and 140.7-203.6 mg/dl, respectively. Hyperglycemia rates of >180 mg/dl in 2008 and 2009 were examined, and hypoglycemia rates of <40 mg/dl (severe) and <70 mg/dl (moderate) in both 2008 and 2009 were calculated.
From these data, hospitals can determine the current state of glycemic control in their hospital and in comparison to other hospitals. For many, glycemic control has improved. Automated POC-BG data management software can assist in this effort.
在美国医院中，成年住院患者的高血糖问题仍是深入研究的课题。大多数医院已制定血糖控制方案，但无法确定其效果。《2009年远程自动化实验室系统（RALS）报告》提供了4年期间576家美国医院的血糖控制趋势，以支持它们管理住院患者高血糖的工作。
一个专有软件应用程序将来自医疗自动化系统RALS-Plus数据管理系统的去识别化患者即时血糖（POC-BG）数据传输到中央服务器。分析内容包括检测次数、重症监护病房（ICU）、非ICU以及每家医院与其他医院汇总数据相比的血糖结果均值和中位数。
2006年至2009年期间提取了超过1.75亿条血糖结果；其中25%来自ICU。2006年、2007年、2008年和2009年所有住院患者的血糖结果平均范围分别为142.2 - 201.9、145.6 - 201.2、140.6 - 205.7和140.7 - 202.4毫克/分升。ICU患者的范围分别为128 - 226.5、119.5 - 219.8、121.
