The association of intravenous insulin and glucose infusion with intensive care unit and hospital mortality: a retrospective study

• Published in: Annals of intensive care 2019-02, Vol.9 (1), p.29-12, Article 29
• Main Authors: van Steen, Sigrid C., Rijkenberg, Saskia, van der Voort, Peter H. J., DeVries, J. Hans
• Format: Article
• Language: English
• Subjects: Anesthesiology; Critical Care Medicine; Critical illness; Emergency Medicine; Glucose; Glycemic control; Hyperglycemia; Inpatient care; Insulin; Intensive; Intensive care; Intensive care unit; Medicine; Medicine & Public Health; Mortality; Quantitative analysis; Risk factors
• ISSN: 2110-5820; 2110-5820
• DOI: 10.1186/s13613-019-0507-x

Background We assessed the association of intravenous insulin and glucose infusion with intensive care unit (ICU) and hospital mortality. Methods For this retrospective association study, we used data from all patients admitted to a medical-surgical ICU between January 2012 and September 2017. We excluded patients admitted  72 h. Results Of 9507 eligible patients, 3966 were included. After correction for potential confounders, intravenous insulin was associated with ICU and hospital mortality in patients admitted > 24 h ( n  = 3966) (odds ratio (OR) 1.09 [95% CI 1.05–1.13] and 1.09 [95% CI 1.06–1.13] per 0.1 IU/kg added, respectively). Likewise, intravenous glucose was associated with ICU mortality (OR 1.01 [95% CI 1.00–1.01]) but not with hospital mortality and (OR 1.00 [95% CI 1.00–1.01]) per g/day added, respectively. In patients admitted > 72 h ( n  = 1550), insulin dose was associated with both ICU and hospital mortality ( p  = 0.002 and p