Hyperglycemia and mortality in critically ill patients

ABSTRACT

To analyze the relation between serum glucose concentration and hospital outcome across the critically ill patients. A single-centre, retrospective study was performed at surgical and medical intensive care unit. Admission glucose, mean morning glucose, mean glucose, maximal glucose and time-averaged glucose levels were calculated for each patient. The time-averaged hyperglycemia was defined as the area under the curve above the upper limit of normal, divided by the total length of stay. Of 300 patients with a median stay of 16 days, the mortality rate was 32%. Mean fasting glucose was 121 mg/dl in survivors versus 160 mg/dl in non survivors [P=0.001]. Mean admission glucose was 127 mg/dl in survivors versus 142 mg/dl in non survivors [0.03]. Median time-averaged hyperglycemia was 4 mg/dl in survivors versus 17.5 mg/dl in nonsurvivors [P < 0.006]. The area under the receiver operator characteristic [ROC] curve was 0.59 for time-averaged glucose and 0.73 for mean fasting glucose. Whereas time-averaged hyperglycema is a useful assessment for glucose control in critically ill patients, it has no priority to admission glucose and mean fasting glucose for outcome prediction