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Between blood glucose and mortality in critically ill patients: Retrospective analysis of the MIMIC-IV database
Yuanyuan Li1, Wenqiang Li1, Baocai Xu2
1Department of ICU, Jining No.1 People's Hospital, Jining, China.
Aims/Introduction:
Mean blood glucose (MBG) level is associated with mortality among critically ill patients. We undertook a cohort study to investigate the relationship between MBG and mortality in critically ill patients.
Materials And Methods:
Critically ill patients were enrolled from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. MBG was calculated to represent the overall glycemic status during intensive care unit (ICU) hospitalization, and a multivariate logistic regression determined the relationship between MBG and ICU mortality in different subgroups of critically ill patients.
Results:
A total of 8,973 patients were included in the study, 1,244 of whom died within 28 days, including 5,402 men and 3,571 women. Multivariate adjusted restricted cubic spline analyses suggested that the relationship between MBG and ICU mortality was a "J" shape. Logistic regression showed 28 day mortality in group 3 (glucose ≥10 mmol/L): the adjusted odds ratio was 2.06 (95% confidence interval 1.65-2.57). The results of subgroup analysis showed that hyperglycemia had a more significant impact on ICU mortality in patients without diabetes, hypoglycemia and liver disease, and the ICU mortality risk of non-diabetes patients was always higher than that of diabetes patients with the same hyperglycemia level.
Conclusions:
Current evidence suggested a J-shaped relationship between MBG and mortality in critically ill patients.
Insights
Mean blood glucose levels in critically ill patients show a J-shaped association with mortality. Higher glucose levels increase the risk of death, particularly in patients without diabetes, hypoglycemia, or liver disease.
Area of Science:
- Critical care medicine
- Endocrinology
- Clinical epidemiology
Background:
- Mean blood glucose (MBG) is a significant predictor of mortality in critically ill patients.
- Understanding the precise relationship between MBG and mortality is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between mean blood glucose (MBG) and intensive care unit (ICU) mortality.
- To explore this relationship across different patient subgroups.
Main Methods:
- A cohort study utilizing the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
- Calculation of MBG to represent overall glycemic status during ICU hospitalization.
- Multivariate logistic regression and restricted cubic spline analyses to determine the MBG-mortality relationship.
Main Results:
- A total of 8,973 patients were analyzed, with 1,244 deaths within 28 days.
- A J-shaped relationship was observed between MBG and ICU mortality.
- Hyperglycemia (glucose ≥10 mmol/L) was associated with increased mortality (adjusted OR 2.06).
- The impact of hyperglycemia on mortality was more pronounced in patients without diabetes, hypoglycemia, or liver disease.
Conclusions:
- A J-shaped relationship exists between MBG and mortality in critically ill patients.
- Hyperglycemia poses a significant mortality risk, especially in specific patient subgroups.
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