Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill

This study examines the likelihood and evolution of overall and hypoglycemia-inducing variability of insulin sensitivity in ICU patients based on diagnosis and day of stay. An analysis of model-based insulin sensitivity for n=390 patients in a medical ICU (Christchurch, New Zealand). Two metrics are...

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Bibliographic Details
Published in:PloS one 2013-02, Vol.8 (2), p.e57119-e57119
Main Authors: Ferenci, Tamás, Benyó, Balázs, Kovács, Levente, Fisk, Liam, Shaw, Geoffrey M, Chase, J Geoffrey
Format: Article
Language:English
Subjects:
Adult
Aged
Analysis
APACHE
Biology
Clinical medicine
Computer Science
Critical care
Critical Illness - epidemiology
Diabetes
Diagnosis
Electrical engineering
Ethics
Evolution
Female
Glucose
Heart
Heart diseases
Hospital patients
Humans
Hypoglycemia
Hypoglycemia - diagnosis
Hypoglycemia - metabolism
Informatics
Information technology
Insulin
Insulin Resistance
Intensive care
Intensive Care Units
Male
Mathematical models
Mathematics
Mechanical engineering
Medical diagnosis
Medicine
Middle Aged
Models, Statistical
Mortality
New Zealand
Patients
Sensitivity
Sensitivity analysis
Statistical analysis
Stochastic models
Stochasticity
Studies
Variability
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Summary:This study examines the likelihood and evolution of overall and hypoglycemia-inducing variability of insulin sensitivity in ICU patients based on diagnosis and day of stay. An analysis of model-based insulin sensitivity for n=390 patients in a medical ICU (Christchurch, New Zealand). Two metrics are defined to measure the variability of a patient's insulin sensitivity relative to predictions of a stochastic model created from the same data for all patients over all days of stay. The first selectively captures large increases related to the risk of hypoglycemia. The second captures overall variability. Distributions of per-patient variability scores were evaluated over different ICU days of stay and for different diagnosis groups based on APACHE III: operative and non-operative cardiac, gastric, all other. Linear and generalized linear mixed effects models assess the statistical significance of differences between groups and over days. Variability defined by the two metrics was not substantially different. Variability was highest on day 1, and decreased over time (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0057119