Prognostic Value of Admission Blood Glucose Level in Critically Ill Patients Admitted to Cardiac Intensive Care Unit According to the Presence or Absence of Diabetes Mellitus

Overview

Journal J Korean Med Sci

Specialty General Medicine

Date 2019 Mar 14

PMID 30863267

Citations 1

Authors

Sua Kim

Soo Jin Na

Taek Kyu Park

Joo Myung Lee

Young Bin Song

Jin-Oh Choi

Joo-Yong Hahn

Jin-Ho Choi

Seung-Hyuk Choi

Hyeon-Cheol Gwon

Chi Ryang Chung

Kyeongman Jeon

Gee Young Suh

Jeong Hoon Yang

Affiliations

Soon will be listed here.

Abstract

Background: Admission blood glucose (BG) level is a predictor of mortality in critically ill patients with various conditions. However, limited data are available regarding this relationship in critically ill patients with cardiovascular diseases according to diabetic status.

Methods: A total of 1,780 patients (595 with diabetes) who were admitted to cardiac intensive care unit (CICU) were enrolled from a single center registry. Admission BG level was defined as maximal serum glucose level within 24 hours of admission. Patients were divided by admission BG level: group 1 (< 7.8 mmol/L), group 2 (7.8-10.9 mmol/L), group 3 (11.0-16.5 mmol/L), and group 4 (≥ 16.6 mmol/L).

Results: A total of 105 patients died in CICU (62 non-diabetic patients [5.2%] and 43 diabetic patients [7.9%]; = 0.105). The CICU mortality rate increased with admission BG level (1.7%, 4.8%, 10.3%, and 18.8% from group 1 to group 4, respectively; < 0.001). On multivariable analysis, hypertension, mechanical ventilator, continuous renal replacement therapy, acute physiology and chronic health evaluation II (APACHE II) score, and admission BG level significantly influenced CICU mortality in non-diabetic patients (group 1 vs. group 3: hazard ratio [HR], 3.31; 95% confidence interval [CI], 1.47-7.44; = 0.004; group 1 vs. group 4: HR, 6.56; 95% CI, 2.76-15.58; < 0.001). However, in diabetic patients, continuous renal replacement therapy and APACHE II score influenced CICU mortality but not admission BG level.

Conclusion: Admission BG level was associated with increased CICU mortality in critically ill, non-diabetic patients admitted to CICU but not in diabetic patients.

Citing Articles

Relationship between Random Blood Glucose, Fasting Blood Glucose, and Gensini Score in Patients with Acute Myocardial Infarction.

Qin Y, Yan G, Qiao Y, Ma C, Liu J, Tang C Biomed Res Int. 2019; 2019:9707513.

PMID: 31737681 PMC: 6815616. DOI: 10.1155/2019/9707513.

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