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Glucose variability and mortality in patients with sepsis
Naeem A Ali1, James M O'Brien, Kathleen Dungan
1Division of Pulmonary, Allergy, Critical Care and Sleep Medicine and Center for Critical Care, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA. naeem.ali@osumc.edu
Critical Care Medicine
|July 4, 2008
Summary
Glucose variability, especially the glycemic lability index, is linked to higher hospital mortality in sepsis patients. Lower average glucose with high variability significantly increases mortality risk.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Clinical Research
Background:
- Hyperglycemia management is crucial for sepsis patients.
- Glucose variability, not just glucose levels, impacts mortality in critically ill patients.
Purpose of the Study:
- To determine the association between glucose variability and hospital mortality in sepsis patients.
- To identify the best measure of glucose variability for predicting mortality risk in sepsis.
Main Methods:
- Retrospective, single-center cohort study of adult sepsis patients.
- Calculated glucose variability using average glucose, standard deviation, mean amplitude of glycemic excursions, and glycemic lability index.
- Used logistic regression to analyze the odds of hospital mortality, adjusting for confounders.
Main Results:
- The glycemic lability index showed the best discrimination for mortality (AUC = 0.67).
- A significant interaction was found between glycemic lability index and average glucose levels regarding mortality.
- Increased glycemic lability index with lower average glucose was associated with a nearly five-fold increase in mortality odds (OR = 4.73).
Conclusions:
- Glucose variability is an independent predictor of hospital mortality in sepsis.
- Further research is needed to explore strategies for reducing glucose variability to improve sepsis patient outcomes.
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