Between blood glucose and mortality in critically ill patients: Retrospective analysis of the MIMIC-IV database

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2024-03-12 DOI:10.1111/jdi.14182

Yuanyuan Li, Wenqiang Li, Baocai Xu

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Abstract

Aims/Introduction

Mean blood glucose (MBG) level is associated with mortality among critically ill patients. We undertook a cohort study to investigate the relationship between MBG and mortality in critically ill patients.

Materials and Methods

Critically ill patients were enrolled from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. MBG was calculated to represent the overall glycemic status during intensive care unit (ICU) hospitalization, and a multivariate logistic regression determined the relationship between MBG and ICU mortality in different subgroups of critically ill patients.

Results

A total of 8,973 patients were included in the study, 1,244 of whom died within 28 days, including 5,402 men and 3,571 women. Multivariate adjusted restricted cubic spline analyses suggested that the relationship between MBG and ICU mortality was a “J” shape. Logistic regression showed 28 day mortality in group 3 (glucose ≥10 mmol/L): the adjusted odds ratio was 2.06 (95% confidence interval 1.65–2.57). The results of subgroup analysis showed that hyperglycemia had a more significant impact on ICU mortality in patients without diabetes, hypoglycemia and liver disease, and the ICU mortality risk of non-diabetes patients was always higher than that of diabetes patients with the same hyperglycemia level.

Conclusions

Current evidence suggested a J-shaped relationship between MBG and mortality in critically ill patients.

Abstract Image

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重症患者血糖与死亡率之间的关系：对 MIMIC-IV 数据库的回顾性分析。

目的/引言：平均血糖（MBG）水平与重症患者的死亡率有关。我们开展了一项队列研究，调查重症患者的平均血糖与死亡率之间的关系：我们从重症监护医学信息市场 IV（MIMIC-IV）数据库中登记了重症患者。计算 MBG 代表重症监护病房（ICU）住院期间的总体血糖状况，并通过多变量逻辑回归确定不同亚组重症患者的 MBG 与 ICU 死亡率之间的关系：研究共纳入了 8,973 名患者，其中 1,244 人在 28 天内死亡，包括 5,402 名男性和 3,571 名女性。多变量调整限制立方样条分析表明，MBG 与重症监护室死亡率之间的关系呈 "J "形。逻辑回归显示，第 3 组（血糖≥10 mmol/L）的 28 天死亡率：调整后的几率比为 2.06（95% 置信区间为 1.65-2.57）。亚组分析结果显示，高血糖对无糖尿病、低血糖和肝病患者的ICU死亡率影响更大，非糖尿病患者的ICU死亡风险始终高于相同高血糖水平的糖尿病患者：目前的证据表明，MBG 与重症患者的死亡率呈 "J "型关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).