Glycemic Variability and Frailty Risk in Intensive Care: A Retrospective Cohort Study of 18 650 Older People

Frailty, a syndrome marked by multisystem decline, is linked to worse outcomes in ICU patients. While glycemic variability (GV) has been associated with prognosis in various diseases, its relationship with frailty risk in ICU patients remains unclear.

This study included 18 650 older patients admitted to the ICU for the first time. GV was quantified using the coefficient of variation (CV) of blood glucose, while frailty was assessed using the Hospital Frailty Risk Score, which classified patients into non-frail and frail groups. The relationship between GV and hospital frailty risk was investigated through the use of multivariate logistic regression models, with supplementary subgroup and sensitivity analyses conducted to ensure the robustness of the findings.

The overall prevalence of hospital frailty risk was 58.4%. Patients in the higher GV group (Log CV ≥ 2.96) exhibited a significantly elevated risk of hospital frailty in comparison to those in the lower GV group (Log CV < 2.96) (adjusted odds ratio = 1.39, 95% confidence interval: 1.31-1.47, p < 0.001). However, further analysis revealed that there was no non-linear relationship between GV and the risk of hospital frailty. Furthermore, the results of the sensitivity and subgroup analyses were in alignment with those of the primary analysis.

The study finds a significant link between elevated GV and increased hospital frailty risk in ICU patients, suggesting that GV may be an independent predictor of hospital frailty risk. Incorporating GV monitoring into routine care could help clinicians improve outcomes and optimize resource allocation for critically ill patients.