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[The correlation analysis between glucose level and its variability and prognosis in traumatic patients]
Zhao-hui Liu1, Lei Su, Jin-chun Wu
1Department of Critical Care Medicine, Guangdong Armed Polished Hospital, Guangzhou, Guangdong, China.
Summary
High glucose levels and variability in traumatic patients are linked to increased mortality. Managing both average glucose (GluAve) and its variability (GluCV) may reduce deaths in trauma care.
Area of Science:
- Critical Care Medicine
- Metabolic Disorders
- Trauma Surgery
Background:
- Hyperglycemia and glucose variability are common in critically ill trauma patients.
- The impact of glucose fluctuations, not just average levels, on outcomes requires further investigation.
Purpose of the Study:
- To examine the association between average glucose (GluAve) and glucose variability (GluCV) and mortality in traumatic patients.
- To determine if controlling glucose levels and variability improves prognosis in trauma care.
Main Methods:
- Retrospective analysis of 300 trauma patients in the ICU.
- Calculation of average glucose (GluAve), glucose standard deviation (GluSD), and glucose coefficient of variation (GluCV) within the first 72 hours.
- Comparison of glucose metrics between survivor and non-survivor groups, with logistic regression analysis for risk factors.
Main Results:
- Non-survivors exhibited significantly higher GluAve, GluSD, and GluCV compared to survivors (P<0.05).
- Mortality increased with higher GluAve and GluCV levels.
- In specific GluAve subgroups, higher GluCV was associated with increased mortality (e.g., 46.15% vs. 9.09% in the 7.8-9.9 mmol/L GluAve group, P<0.01).
- Multivariable analysis identified GluAve (OR=1.150) and GluCV (OR=1.022) as independent risk factors for mortality.
Conclusions:
- Elevated average glucose and glucose variability are significant predictors of mortality in traumatic patients.
- Controlling both the level and variability of blood glucose is crucial for reducing mortality in severe trauma cases.
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