Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database
Abstract Blood glucose management in intensive care units (ICU) remains a controversial topic. We assessed the association between time-weighted average glucose (TWAG) levels and ICU mortality in critically ill patients in a real-world study. This retrospective study included critically ill patients...
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Nature Portfolio
2024-02-01
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| Online Access: | https://doi.org/10.1038/s41598-024-55504-9 |
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| author | Mengwen Feng Jing Zhou |
| author_facet | Mengwen Feng Jing Zhou |
| author_sort | Mengwen Feng |
| collection | DOAJ |
| description | Abstract Blood glucose management in intensive care units (ICU) remains a controversial topic. We assessed the association between time-weighted average glucose (TWAG) levels and ICU mortality in critically ill patients in a real-world study. This retrospective study included critically ill patients from the Medical Information Mart for Intensive Care IV database. Glycemic distance is the difference between TWAG in the ICU and preadmission usual glycemia assessed with glycated hemoglobin at ICU admission. The TWAG and glycemic distance were divided into 4 groups and 3 groups, and their associations with ICU mortality risk were evaluated using multivariate logistic regression. Restricted cubic splines were used to explore the non-linear relationship. A total of 4737 adult patients were included. After adjusting for covariates, compared with TWAG ≤ 110 mg/dL, the odds ratios (ORs) of the TWAG > 110 mg/dL groups were 1.62 (95% CI 0.97–2.84, p = 0.075), 3.41 (95% CI 1.97–6.15, p < 0.05), and 6.62 (95% CI 3.6–12.6, p < 0.05). Compared with glycemic distance at − 15.1–20.1 mg/dL, the ORs of lower or higher groups were 0.78 (95% CI 0.50–1.21, p = 0.3) and 2.84 (95% CI 2.12–3.82, p < 0.05). The effect of hyperglycemia on ICU mortality was more pronounced in non-diabetic and non-septic patients. TWAG showed a U-shaped relationship with ICU mortality risk, and the mortality risk was minimal at 111 mg/dL. Maintaining glycemic distance ≤ 20.1 mg/dL may be beneficial. In different subgroups, the impact of hyperglycemia varied. |
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| language | English |
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| spelling | doaj.art-012fa45a73144285b188e4541a72ad5a2024-03-05T18:38:36ZengNature PortfolioScientific Reports2045-23222024-02-0114111010.1038/s41598-024-55504-9Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV databaseMengwen Feng0Jing Zhou1Department of Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Geriatric Intensive Care Medicine, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Blood glucose management in intensive care units (ICU) remains a controversial topic. We assessed the association between time-weighted average glucose (TWAG) levels and ICU mortality in critically ill patients in a real-world study. This retrospective study included critically ill patients from the Medical Information Mart for Intensive Care IV database. Glycemic distance is the difference between TWAG in the ICU and preadmission usual glycemia assessed with glycated hemoglobin at ICU admission. The TWAG and glycemic distance were divided into 4 groups and 3 groups, and their associations with ICU mortality risk were evaluated using multivariate logistic regression. Restricted cubic splines were used to explore the non-linear relationship. A total of 4737 adult patients were included. After adjusting for covariates, compared with TWAG ≤ 110 mg/dL, the odds ratios (ORs) of the TWAG > 110 mg/dL groups were 1.62 (95% CI 0.97–2.84, p = 0.075), 3.41 (95% CI 1.97–6.15, p < 0.05), and 6.62 (95% CI 3.6–12.6, p < 0.05). Compared with glycemic distance at − 15.1–20.1 mg/dL, the ORs of lower or higher groups were 0.78 (95% CI 0.50–1.21, p = 0.3) and 2.84 (95% CI 2.12–3.82, p < 0.05). The effect of hyperglycemia on ICU mortality was more pronounced in non-diabetic and non-septic patients. TWAG showed a U-shaped relationship with ICU mortality risk, and the mortality risk was minimal at 111 mg/dL. Maintaining glycemic distance ≤ 20.1 mg/dL may be beneficial. In different subgroups, the impact of hyperglycemia varied.https://doi.org/10.1038/s41598-024-55504-9Critical careGlycemia controlMortalityRestricted cubic splines regressionMIMIC-IV |
| spellingShingle | Mengwen Feng Jing Zhou Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database Scientific Reports Critical care Glycemia control Mortality Restricted cubic splines regression MIMIC-IV |
| title | Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database |
| title_full | Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database |
| title_fullStr | Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database |
| title_full_unstemmed | Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database |
| title_short | Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database |
| title_sort | relationship between time weighted average glucose and mortality in critically ill patients a retrospective analysis of the mimic iv database |
| topic | Critical care Glycemia control Mortality Restricted cubic splines regression MIMIC-IV |
| url | https://doi.org/10.1038/s41598-024-55504-9 |
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