A minimum blood glucose value less than or equal to 120 mg/dL under glycemic control is associated with increased 14-day mortality in nondiabetic intensive care unit patients with sepsis and stress hyperglycemia

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• 作者：Ming-Cheng Chan ; MD^a ; ^b ; Jeng-Sen Tseng ; MD^b ; ^f ; Kuo-Hsuan Hsu ; MD^c ; Sou-Jen Shih ; RN ; MSN^d ; Chi-Yuan Yi ; RN^d ; Chieh-Liang Wu ; MD ; PhD^e ; Yu Ru Kou ; PhD^a ; ^{yrkou@ym.edu.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Sepsis ; Glycemic control ; Diabetes
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：34
• 期：Complete
• 页码：69-73
• 全文大小：225 K

文摘

Hyperglycemia is common in critically ill patients, but results of previous trials on glycemic control have been controversial. This study aimed to investigate whether the minimum blood glucose value during the first 72 hours after admission (72-min-BGV) was associated with mortality in patients with severe sepsis.

Materials and methods

This is a retrospective analysis of prospectively acquired clinical data from an intensive care unit of a tertiary referral hospital in central Taiwan. Patients were included if they were admitted due to severe sepsis from July 2010 to June 2011.

Results

A total of 127 patients (100 males and 27 females) were included for analysis. A 72-min-BGV less than or equal to 120 mg/dL was associated with increased 14-day mortality. Further subgroup analysis revealed that this association existed only in the patients without diabetes. In multivariate logistic regression analysis, a 72-min-BGV less than or equal to 120 mg/dL was an independent risk factor for 14-day mortality (adjusted odds ratio, 5.09; 95% confidence interval, 1.26-23.33; P= .024) in the patients without diabetes.

Conclusions

A 72-min-BGV less than or equal to 120 mg/dL was an independent risk factor for 14-day mortality in nondiabetic patients with hyperglycemia admitted to our intensive care unit due to severe sepsis, but not in diabetic patients under the same setting.