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Hyperglycemia increases infection risk in older patients with AML

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Hyperglycemia appears common in patients aged older than 65 years with acute myeloid leukemia and increased risk for infection, according to results of a retrospective record review presented at the Oncology Nursing Society Annual Congress.

Although hyperglycemia is a great concern for patients with AML during induction who are at risk for infection, there have been a lack of data on the prevalence and impact of hyperglycemia.

“The study purpose was to determine the prevalence of hyperglycemia and its role on health outcomes such as neutropenic days, infection and hospital length of stay in patients with AML during induction therapy,” Susan Storey, PhD, RN, AOCNS, visiting assistant scientist at Indiana University School of Nursing, and colleagues wrote.

Storey and colleagues analyzed data from 103 patients with AML who were hospitalized for initial induction chemotherapy. Forty-one patients were aged 65 years or older.

Researchers defined hyperglycemia as having mean serum fasting blood glucose (FBG) or 126 mg/dL or higher.

Overall, 26.5% of the population had hyperglycemia; however, the rate was higher among older patients (37%).

In general, hyperglycemia was not associated with health outcomes.

Patients aged 65 years or older with hyperglycemia experienced increased risk for infection compared with their younger counterparts (OR = 5.6, 95% CI, 1.43-22.2).

Older patients also had 2.5 more neutropenic days — defined as the number of days with absolute neutrophil count fewer than 500 cells/mm² — and 1.5 days longer of hospital stay from admission to re-induction, discharge or death. However, these differences were not statistically significant.

“More research is warranted to elucidate clinically significant levels of hyperglycemia and its impact on health outcomes,” Storey and colleagues wrote. “Oncology nurses should assess and collaborate with other members of the healthcare team to implement strategies to prevent or mitigate the harmful consequences of hyperglycemia.” – by Nick Andrews

Reference : Storey S and Von Ah D. Abstract 167. Presented at: ONS Annual Congress; April 28-May 1, 2016; San Antonio, Texas.

Disclosure : The researchers report no relevant financial disclosures.