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应激性高血糖对一组巴西新冠肺炎患者的影响。

Impact of Stress Hyperglycemia in a Cohort of Brazilian Patients With COVID-19.

作者信息

de Magalhães Pina Ana Julia, Fernando de Oliveira Luís, de Oliveira Nascimento Letícia, Maciel Cavalcanti Rosa Deborah, Barela Jefferson, Martinelli Bruno, Antonio Negrato Carlos

机构信息

Faculdade de Medicina da Universidade de São Paulo (FMBRU), Bauru, SP, Brazil.

Unisagrado - Bauru, Bauru, SP, Brazil.

出版信息

Am J Med Open. 2025 May 9;14:100101. doi: 10.1016/j.ajmo.2025.100101. eCollection 2025 Dec.

Abstract

PURPOSE

To evaluate the impact of stress hyperglycemia (SH) in a cohort of Brazilian patients with COVID-19 admitted to a tertiary care level hospital.

METHODS

This retrospective cohort study enrolled 754 patients with COVID-19 hospitalized at Hospital Estadual de Bauru, São Paulo, in 2020. Data were collected from the E-pront system and covered sociodemographic, clinical, and laboratory aspects, including mechanical ventilation, comorbidities, and outcomes. Included patients were those >18 years old, with confirmed COVID-19 diagnosis, who required hospitalization, with or without preexisting type 2 diabetes (T2DM), or who developed SH. Patients younger than 18 years, with other types of diabetes, or incomplete data were excluded.

RESULTS

Patients with SH had longer hospital and intensive care unit (ICU) stay ( < .001) as well as longer mechanical ventilation duration ( < .001). Additionally, this group needed a higher number of orotracheal intubations ( < .001) and presented higher mortality rates ( < .001) and fewer discharges 284 ( < .001) compared to patients with T2DM and normoglycemia.

CONCLUSIONS

Patients who developed SH presented poorer clinical outcomes; needed more frequently orotracheal intubation, mechanical ventilation, and longer hospitalization and ICU stay; and had higher mortality rates and fewer discharges compared to patients with T2DM and normoglycemia.

摘要

目的

评估应激性高血糖(SH)对一群入住三级医疗机构的巴西新冠肺炎患者的影响。

方法

这项回顾性队列研究纳入了2020年在圣保罗州包鲁医院住院的754例新冠肺炎患者。数据从电子病历系统收集,涵盖社会人口学、临床和实验室方面,包括机械通气、合并症和结局。纳入的患者为年龄大于18岁、确诊新冠肺炎、需要住院治疗、无论是否患有2型糖尿病(T2DM)或发生应激性高血糖的患者。排除年龄小于18岁、患有其他类型糖尿病或数据不完整的患者。

结果

与T2DM患者和血糖正常患者相比,发生应激性高血糖的患者住院时间和重症监护病房(ICU)停留时间更长(P <.001),机械通气持续时间也更长(P <.001)。此外,该组患者需要更多次经口气管插管(P <.001),死亡率更高(P <.001),出院人数更少(P <.001)。

结论

与T2DM患者和血糖正常患者相比,发生应激性高血糖的患者临床结局较差;更频繁地需要经口气管插管、机械通气,住院时间和ICU停留时间更长;死亡率更高,出院人数更少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/addd/12179607/f68521f472b6/gr1.jpg

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