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Published on: June 11, 2012
Glycaemic fluctuation predicts mortality in critically ill patients
H M Al-Dorzi1, H M Tamim, Y M Arabi
1Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Anaesthesia and Intensive Care
|August 19, 2010
Summary
High blood glucose fluctuation in critically ill patients is linked to increased mortality. This study identified age, diabetes, and insulin dose as predictors of this variability, highlighting its independent association with higher death rates.
Area of Science:
- Critical care medicine
- Endocrinology
- Metabolic disorders
Background:
- Glycaemic variability is increasingly linked to diabetic complications.
- Its impact on critically ill patients' outcomes remains poorly understood.
Purpose of the Study:
- To identify predictors of glycaemic fluctuation in critically ill patients.
- To assess the association between glycaemic fluctuation and intensive care unit (ICU) outcomes.
Main Methods:
- A nested-cohort study of 523 medical-surgical ICU patients from a clinical trial.
- Patients received either intensive or conventional insulin therapy.
- Glycaemic fluctuation measured as mean daily blood glucose difference; groups defined by median (6.0 mmol/l).
Main Results:
- Age, diabetes mellitus, and daily insulin dose predicted glycaemic fluctuation.
- Similar fluctuation levels were seen in both intensive and conventional insulin therapy groups.
- Wide glycaemic fluctuation was significantly associated with higher ICU and hospital mortality (22.2% vs. 8.4%, P < 0.001).
Conclusions:
- Wide glycaemic fluctuation is an independent predictor of mortality in critically ill patients.
- Further research is needed to determine if reducing glycaemic fluctuation improves outcomes.
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