Uncovering the predictive value of minimum blood glucose through statistical analysis of a large clinical dataset

The clinical utility and risk of strict glycemic control during critical care have been under intense debate. This study aims to elucidate the relationship between glycemic status and patient outcome in an integrated database collected at a tertiary teaching hospital. Clinical data of 16,135 critically ill adult patients with blood glucose measurements were extracted. The lowest blood glucose levels were analyzed against patient outcome. Major findings are 1) mortality of non-diabetic patients who experience persistent hyperglycemia during intensive care rises with increasing hyperglycemia, 2) minimum blood glucose concentration within the 80-110 mg/dL range corresponds to the highest percentage of survival among patients receiving insulin, and 3) inhospital mortality among patients receiving insulin increases as blood glucose concentration falls into the hypoglycemic range. These results suggest that glycemic status and patient outcome are closely associated and the lowest blood glucose concentration that each patient experiences predicts the patient's eventual outcome.