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在重症患者的血糖和死亡率之间:MIMIC-IV数据库的回顾性分析
Yuanyuan Li1, Wenqiang Li1, Baocai Xu2
1Department of ICU, Jining No.1 People's Hospital, Jining, China.
Journal of diabetes investigation
|March 12, 2024
概括
危急病患者的平均血糖水平显示了与死亡率的J形关联. 较高的葡萄糖水平增加死亡风险,特别是在没有糖尿病,低血糖或肝脏疾病的患者中.
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.
- 临床流行病学临床流行病学
背景情况:
- 平均血糖 (MBG) 是重症患者死亡率的重要预测指标.
- 了解MBG和死亡率之间的准确关系对于改善患者的治疗结果至关重要.
研究的目的:
- 调查平均血糖 (MBG) 和重症监护室 (ICU) 死亡率之间的关联.
- 为了探索不同患者子组之间的这种关系.
主要方法:
- 一项使用密集护理IV (MIMIC-IV) 数据库的医学信息中心的队列研究.
- 计算MBG以表示ICU住院期间的整体血糖状况.
- 多变量逻辑回归和受限立方线分析以确定MBG-死亡率关系.
主要成果:
- 总共有8,973名患者被分析,其中1,244人在28天内死亡.
- 在MBG和ICU死亡率之间观察到J形关系.
- 高血糖 (葡萄糖≥10 mmol/L) 与死亡率增加有关 (调整为OR2.06).
- 过高血糖对死亡率的影响在没有糖尿病,低血糖或肝病的患者中更为明显.
结论:
- 在重症患者的MBG和死亡率之间存在J形关系.
- 高血糖症具有显著的死亡风险,特别是在特定的患者亚组中.
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