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在重症监护机构的低血糖症. 第二部分:相对和绝对低血糖
Greg Roberts1, James S Krinsley2, Jean-Charles Preiser3
1SA Pharmacy, Flinders Medical Centre, Bedford Park, SA 5042, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia.
相对低血糖,定义为低于0.7的血糖比率 (GR) 在HbA1c≥8%的患者中,显著增加死亡风险. 绝对低血糖 (血糖<70 mg/dL) 也与所有HbA1c水平的死亡率相关.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 临床研究是临床研究.
背景情况:
- 低血糖,无论是相对的还是绝对的,都是重症监护中的一个问题.
- 不同类型的低血糖和死亡率之间的确切关系需要进一步研究.
研究的目的:
- 评估医院死亡率与相对低血糖 (使用血糖比率) 和绝对低血糖 (使用血糖水平) 之间的风险调整关联.
主要方法:
- 在4790名患者的回顾性队列研究中.
- 使用血糖比率 (GR) < 0.7.7 的相对低血糖的分析.
- 使用血糖 (BG) < 70 mg/dL 的绝对低血糖的分析.
主要成果:
- 在HbA1c≥8%的患者中,相对低血糖 (GR<0.7) 与死亡率增加 (OR2.49) 独立相关.
- 在HbA1c<8% (或0.98) 的患者中没有观察到这种关联.
- 绝对低血糖症在HbA1c频谱中显示出U形模式,小时低于70 mg/dL显示出与死亡率的最强相关性.
结论:
- 相对低血糖,特别是在HbA1c≥8%的患者中,GR低于0.7的游览是常见的,并且与死亡率有独立的联系.
- 绝对低血糖症与死亡率有关,无论HbA1c水平如何.
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