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The Association Between Glycemic Variability and Mortality in Critically Ill Patients: A Multicenter Prospective

Ömer Emgin1, Mehmet Yavuz2, Adem Şahin3

  • 1Department of Intensive Care Unit, Tepecik Training and Research Hospital, Konak, Izmir 35020, Turkey.

Journal of Clinical Medicine
|November 27, 2024
PubMed
Summary

High glycemic variability (GV) in critically ill patients, measured by the coefficient of variation (CV) within 24 hours, independently predicts 28-day mortality. Mean glucose difference (MGD) also correlates with mortality risk.

Keywords:
coefficient of variationglycemic variabilityintensive caremaximal glycemic differencemortality

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Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Clinical Research

Background:

  • Glycemic variability (GV) is common in critically ill patients.
  • Early identification of GV markers can predict patient outcomes.
  • Understanding GV's impact is crucial for managing intensive care unit (ICU) patients.

Purpose of the Study:

  • To investigate the association between early glycemic variability parameters and 28-day mortality in critically ill patients.
  • To identify specific GV metrics predictive of mortality.
  • To explore the relationship between different GV measures.

Main Methods:

  • A prospective, observational study involving 578 critically ill patients across five Turkish ICUs.
  • Recorded glycemic variability parameters (SD, MGL, MGD, CV) within the first 24 hours of ICU admission.
  • Utilized multivariate logistic regression and Spearman's rho correlation for analysis.

Main Results:

  • Patients with higher CV, SD, and MGD showed increased 28-day mortality.
  • The coefficient of variation (CV) was identified as an independent predictor of mortality (OR 1.023, p=0.017).
  • A strong correlation (r=0.871, p<0.001) was found between CV and MGD.

Conclusions:

  • Early CV in critically ill patients is independently linked to 28-day mortality.
  • MGD shows a strong correlation with CV and may serve as a bedside tool for mortality risk assessment.
  • Further research is needed to confirm MGD's independent association with mortality.