心力衰竭重症患者早期血糖动态轨迹与死亡率之间的关系:来自真实世界数据的启示。

IF 6.1 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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引用次数: 0

摘要

目的:本研究旨在探讨重症监护病房(ICU)入院最初 48 小时内的早期动态血糖(BG)轨迹对重症心力衰竭(HF)患者死亡率的影响:该研究采用了回顾性观察设计,分析了重症监护医学信息市场IV数据库中心衰患者的动态血糖数据。采用基于动态时间平移算法的分层聚类方法确定了血压轨迹亚型。研究的主要结果是 28 天死亡率,次要结果包括 180 天和 1 年死亡率:我们共筛选了 21,098 名高血压患者,最终有 15,092 名患者被纳入研究。我们的研究结果发现了三种不同的 BG 轨迹亚型:增加型(n = 3503)、稳定型(n = 6250)和减少型(n = 5339)。血糖升高亚型与 28 天、180 天和 1 年的最高死亡风险相关。稳定亚型和下降亚型在所有时间点的死亡风险都明显较低,危险比在 0.85 至 0.88 之间(PConclusions:入院 48 小时内血压升高轨迹与心房颤动患者死亡率升高密切相关。有必要更加关注心房颤动患者的早期血糖动态变化,以优化临床血糖管理,改善患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Association between early blood glucose dynamic trajectory and mortality for critically ill patients with heart failure: Insights from real-world data

Association between early blood glucose dynamic trajectory and mortality for critically ill patients with heart failure: Insights from real-world data

Aims

This study endeavors to explore the ramifications of early dynamic blood glucose (BG) trajectories within the initial 48 h of intensive care unit (ICU) admission on mortality among critically ill heart failure (HF) patients.

Methods

The study employed a retrospective observational design, analyzing dynamic BG data of HF patients from the Medical Information Mart for Intensive Care IV database. The BG trajectory subphenotypes were identified using the hierarchical clustering based on the dynamic time-warping algorithm. The primary outcome of the study was 28-day mortality, with secondary outcomes including 180-day and 1-year mortality.

Results

We screened a total of 21,098 HF patients and finally 15,092 patients were included in the study. Our results identified three distinct BG trajectory subphenotypes: increasing (n = 3503), stabilizing (n = 6250), and decreasing (n = 5339). The increasing subphenotype was associated with the highest mortality risk at 28 days, 180 days, and 1 year. The stabilizing and decreasing subphenotypes showed significantly lower mortality risks across all time points, with hazard ratios ranging from 0.85 to 0.88 (P<0.05 for all). Sensitivity analyses confirmed the robustness of these findings after adjusting for various covariates.

Conclusions

Increasing BG trajectory within 48 h of admission is significantly associated with higher mortality in patients with HF. It is necessary to devote greater attention to the early BG dynamic changes in HF patients to optimize clinical BG management and enhance patient prognosis.

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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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