Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
Abstract There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-13816-8 |
| _version_ | 1818237415216644096 |
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| author | Bojan Hartmann Marlo Verket Paul Balfanz Niels-Ulrik Hartmann Malte Jacobsen Julia Brandts Michael Dreher Nils Kossack Dennis Häckl Nikolaus Marx Dirk Müller-Wieland |
| author_facet | Bojan Hartmann Marlo Verket Paul Balfanz Niels-Ulrik Hartmann Malte Jacobsen Julia Brandts Michael Dreher Nils Kossack Dennis Häckl Nikolaus Marx Dirk Müller-Wieland |
| author_sort | Bojan Hartmann |
| collection | DOAJ |
| description | Abstract There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic variability on survival has not been explored in patients with COVID-19 and ARDS. This single-centre cohort study compared several metrics of glycaemic variability for goodness-of-fit in patients requiring mechanical ventilation due to COVID-19 ARDS in the ICU at University Hospital Aachen, Germany. 106 patients had moderate to severe ARDS (P/F ratio median [IQR]: 112 [87–148] mmHg). Continuous HRs showed a proportional increase in mortality risk with daily glycaemic variability (DGV). Multivariable unadjusted and adjusted Cox-models showed a statistically significant difference in mortality for DGV (HR: 1.02, (P) < 0.001, LR(P) < 0.001; HR: 1.016, (P) = 0.001, LR(P) < 0.001, respectively). Kaplan–Meier estimators yielded a shorter median survival (25 vs. 87 days) and a higher likelihood of death (75% vs. 31%) in patients with DGV ≥ 25.5 mg/dl (P < 0.0001). High glycaemic variability during ICU admission is associated with significant increase in all-cause mortality for patients admitted with COVID-19 ARDS to the ICU. This effect persisted even after adjustment for clinically predetermined confounders, including diabetes, median procalcitonin and FPG. |
| first_indexed | 2024-12-12T12:25:24Z |
| format | Article |
| id | doaj.art-a7867f5eb7de434b97b209c12b5fe46d |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-12T12:25:24Z |
| publishDate | 2022-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-a7867f5eb7de434b97b209c12b5fe46d2022-12-22T00:24:33ZengNature PortfolioScientific Reports2045-23222022-06-0112111010.1038/s41598-022-13816-8Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort studyBojan Hartmann0Marlo Verket1Paul Balfanz2Niels-Ulrik Hartmann3Malte Jacobsen4Julia Brandts5Michael Dreher6Nils Kossack7Dennis Häckl8Nikolaus Marx9Dirk Müller-Wieland10Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Pneumology and Intensive Care Medicine, University Hospital AachenWIG2 – Scientific Institute for Health Economics and Health System ResearchFaculty of Economics and Management Science, University LeipzigDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenDepartment of Cardiology, Angiology and Intensive Care Medicine, University Hospital AachenAbstract There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic variability on survival has not been explored in patients with COVID-19 and ARDS. This single-centre cohort study compared several metrics of glycaemic variability for goodness-of-fit in patients requiring mechanical ventilation due to COVID-19 ARDS in the ICU at University Hospital Aachen, Germany. 106 patients had moderate to severe ARDS (P/F ratio median [IQR]: 112 [87–148] mmHg). Continuous HRs showed a proportional increase in mortality risk with daily glycaemic variability (DGV). Multivariable unadjusted and adjusted Cox-models showed a statistically significant difference in mortality for DGV (HR: 1.02, (P) < 0.001, LR(P) < 0.001; HR: 1.016, (P) = 0.001, LR(P) < 0.001, respectively). Kaplan–Meier estimators yielded a shorter median survival (25 vs. 87 days) and a higher likelihood of death (75% vs. 31%) in patients with DGV ≥ 25.5 mg/dl (P < 0.0001). High glycaemic variability during ICU admission is associated with significant increase in all-cause mortality for patients admitted with COVID-19 ARDS to the ICU. This effect persisted even after adjustment for clinically predetermined confounders, including diabetes, median procalcitonin and FPG.https://doi.org/10.1038/s41598-022-13816-8 |
| spellingShingle | Bojan Hartmann Marlo Verket Paul Balfanz Niels-Ulrik Hartmann Malte Jacobsen Julia Brandts Michael Dreher Nils Kossack Dennis Häckl Nikolaus Marx Dirk Müller-Wieland Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study Scientific Reports |
| title | Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study |
| title_full | Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study |
| title_fullStr | Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study |
| title_full_unstemmed | Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study |
| title_short | Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study |
| title_sort | glycaemic variability is associated with all cause mortality in covid 19 patients with ards a retrospective subcohort study |
| url | https://doi.org/10.1038/s41598-022-13816-8 |
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