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关键病患者的高血糖与死亡相关的临界值:一个多中心,前性,使用持续血糖监测的观察性研究
Yaxin Wang1, Siwan Li2,3, Jingyi Lu1
1Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
重症患者的持续血糖监测 (CGM) 显示,长期高血糖超过10.5mmol/l (190mg/dl) 显著增加死亡风险. 这一发现有助于确定关键高血糖门,以改善患者的治疗结果.
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.
- 医疗技术 医疗技术 医学技术
背景情况:
- 持续血糖监测 (CGM) 提供了详细的洞察力,了解危急病患者的血糖变化.
- 了解高血糖门对于管理重症监护病房死亡风险至关重要.
研究的目的:
- 确定高血糖的具体门,通过CGM测量,与严重病情的成年人医院死亡风险增加有关.
- 评估时间超出范围 (TAR) 和时间在范围 (TIR) 和死亡率之间的关系.
主要方法:
- 在五个医疗中心对293名严重病情的成年患者进行前性研究.
- 间歇扫描的CGM使用了12天的中位数.
- 多变量考克斯回归分析了TAR/TIR值 (7.8-13.9 mmol/l) 和住院死亡率之间的关联.
主要成果:
- 在葡萄糖水平为10.5 mmol/l (190 mg/dl) 和更高时,发现时间超出范围 (TAR) 与死亡率的显著关联.
- 增加TAR值逐渐增加死亡风险.
- 在3.9-10.5mmol/l之间的时间范围 (TIR) 减少了10%,与死亡风险增加了12.1%.
结论:
- 超过10.5 mmol/l (190 mg/dl) 的高血糖是重症患者住院死亡率的重要预测因素.
- CGM数据,特别是TAR和TIR,为这个患者群体提供了有价值的预后信息.
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