Effect of blood-sugar limitation on intensive care mortality: Intragroup evaluation

Objective To evaluate the safety profile of blood sugar limits in intensive care unit (ICU) patients. Methods Adult patients with ICU stay >36 h, more than two blood sugar measurements and antibiotic therapy concordant with locally adapted guidelines were included. For analyses, one study cohort...

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Bibliographic Details
Published in:Journal of international medical research 2015-08, Vol.43 (4), p.560-572
Main Authors: Nachtigall, Irit, Tafelski, Sascha, Tamarkin, Andrey, Rothbart, Andreas, Lange, Martin, Wegener, Felix, Balzer, Felix, Burgos, Jack Poul Luengas, Wernecke, Klaus-Dieter, Spies, Claudia
Format: Article
Language:English
Subjects:
Adult
Aged
Blood Glucose - analysis
Communicable Diseases - etiology
Critical Care - statistics & numerical data
Demography
Female
Hospital Mortality
Humans
Hypoglycemia - etiology
Logistic Models
Male
Middle Aged
Multivariate Analysis
Respiration, Artificial
Treatment Outcome
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Summary:Objective To evaluate the safety profile of blood sugar limits in intensive care unit (ICU) patients. Methods Adult patients with ICU stay >36 h, more than two blood sugar measurements and antibiotic therapy concordant with locally adapted guidelines were included. For analyses, one study cohort was defined in two ways: as a narrow group, euglycaemic patients’ blood sugar levels 80–150 mg/dl; as a moderate group, euglycaemic patients’ blood sugar levels 80–180 mg/dl. Dysglycaemia was defined as blood sugar levels 5% of measurements, and >150 mg/dl or >180 mg/dl (narrow or moderate groups, respectively) for >10% of measurements. The primary endpoint was ICU mortality (euglycaemia versus dysglycaemia). Results The study comprised 668 patients. When defined as a narrow group, ICU mortality was 3% (four of 135) euglycaemic versus 10% (54/533) dysglycaemic patients (odds ratio [OR] 3.692, 95% confidence interval [CI] 1.313, 10.382). When defined as a moderate group, ICU mortality was 6% (21/351) euglycaemic versus 12% (37/317) dysglycaemic patients (OR 2.077, 95% CI 1.188, 3.630). Frequency of severe hypoglycaemia (blood sugar
ISSN:0300-0605
1473-2300
DOI:10.1177/0300060514566651