Impact of Admission Hyperglycemia on In-hospital arrhythmia in medical critical illness

Background Admission hyperglycemia is frequently encountered in critically ill patients, even in the absence of pre-existing diabetes. Acute stress hyperglycemia triggers autonomic activation, oxidative stress, and electrophysiological disturbances that may predispose to cardiac arrhythmias. Aim of work The present study aimed to explore the frequency and type of arrhythmic events among critically ill patients with admission hyperglycemia in medical intensive care units (MICU). Methods: A prospective study was conducted on 354 critically ill ICU patients . They were divided into group A with admission hyperglycemia (>180 mg/dL) and group B with admission normoglycemia (≤180 mg/dL). All patients were subjected to full clinical assessment, laboratory testing, Sequential organ assessment score (SOFA) and Charlson Comorbidity Index scoring(CCI), initial ECG on admission , continuous ECG monitoring , hourly ECG during the 1st day of ICU stay and echocardiography. Any arrhythmic event during the first 24hours was reported. HR fluctuation during the first day of admission was calculated. In-hospital mortality, vasopressor use and mechanical ventilation(MV) need were reported. Results: Arrhythmias were significantly more frequent in patients with admission hyperglycemia (26.6% vs. 9.6%, p