Glucose variability is associated with high mortality after severe burn

Area of Science:

• Critical Care Medicine
• Metabolic Disorders
• Burn Injury Management

Background:

• Hyperglycemia increases mortality in severe injuries.
• Intensive insulin protocols improve outcomes but glycemic variability poses challenges.
• Glycemic variability may indicate poor prognosis in critically ill patients.

Purpose of the Study:

• To investigate if glycemic variability alone can identify burn patients at higher risk of death.
• To assess the association between glucose variability and mortality in severely burned patients.

Main Methods:

• Analysis of burn patients with >20% total body surface area burned and intensive insulin therapy.
• Glycemic variability calculated as the sum of percent glucose excursions outside the 80-110 mg/dL target range.
• Comparison of mortality rates between high and low glycemic variability groups.

Main Results:

• Severely burned patients with high glucose variability (56% excursions) had twice the mortality rate (50%) compared to those with low variability (43% excursions, 22% mortality).
• No significant differences were observed in injury severity, demographics, or length of hospital stay between groups.
• High glucose variability was defined as >50% of glucose measurements outside the 80-110 mg/dL range.

Conclusions:

• Elevated glucose variability is a significant predictor of increased mortality in severely burned patients.
• Frequent deviations from the target glucose range (80-110 mg/dL) indicate a higher risk of death.
• Glycemic variability serves as a crucial marker for patient risk stratification in burn care.