Effects of Computerized Decision Support Systems On Blood Glucose Regulation in Critically Ill Surgical Patients

Case Study

Background:

The use of computerized decision support systems (CDSS) in glucose control for critically ill surgical patients has been reported in both diabetic and nondiabetic patients. Prospective studies evaluating its effect on glucose control are, however, lacking. The objective of this study was to evaluate patient-specific computerized IV insulin dosing on blood glucose levels (BGLs) by comparing patients treated pre-CDSS with those treated post-CDSS.

Conclusions

Patients whose BGLs were managed using CDSS were statistically significantly more likely to have a glucose reading under control (<150 mg/dL) than in the 6-month historical controls and to avoid serious hypoglycemia (p < 0.0001).

Using CDSS Improves Glucose Control

Improved Percentage of Hyperglycemic Events

Blood glucose levels of >150 mg/dL decreased by 50%.

Avoid Hypoglycemic Events

Severe hypoglycemia (defined as BGL <40 mg/dL) decreased from 1% to 0.05%.

Decrease in Total Number of BG Checks

Total number of blood glucose checks decreased an average of 46%.

Publication Information

Author(s): Sandy L. Fogel, MD, FACS and Christopher C. Baker, MD, FACS

Location: Department of Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA

Source: American College of Surgeons. 2013 Apr;216(4):828-33; discussion 833-5.