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

Kim, Sua; Na, Soo Jin; Park, Taek Kyu; Lee, Joo Myung; Song, Young Bin; Choi, Jin-Oh; Hahn, Joo Yong; Choi, Seung–Hyuk; Gwon, Hyeon‐Cheol; Chung, Chi Ryang; Jeon, Kyeongman; Suh, Gee Young; Yang, Jeong Hoon

doi:10.3346/jkms.2019.34.e70

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…Admission ICU BGL was a predictor for mortality in critically ill patients. In ST-segment elevation myocardial infarction complicated by cardiogenic shock, admission BGL is an independent predictor of increased risk of death only among patients without DM [27], Kim and colleges also found admission BGL was associated with increased cardiac ICU mortality in non-DM critically ill individuals but not in critically ill patients who had DM [28]. In our research, we demonstrated patients with a history of DM in comparison with nondiabetics had signi cantly higher crude ICU mortality rate when the rst ICU admission glucose levels were low (i.e., < 103 mg/dL).…”

Section: Discussionmentioning

confidence: 94%

Diabetes mellitus is associated with lower mortality in intensive care unit: a multicenter historical cohort study

Hu¹,

Hu²,

Wang³

et al. 2020

Preprint

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Background: The association of pre-existing diabetes mellitus and outcomes among critically ill patients remains unknown.Methods: This retrospective study enrolled patients who were covered by the eICU Collaborative Research Database from 2014 to 2015. DM was the exposure of interest, and diabetic individuals were adjudicated by the medical history, and blood glucose level (BGL). We abstracted basic characteristics, laboratory variables, and primary exposures. ICU mortality was the primary outcome.Results: In a cohort of 134,429 critically ill patients (male 54.4%, median age 66 [54-77] years, BMI 28[24-33] kg/m2), the prevalence of DM was 29%. In comparison with nondiabetics, DM patients were older, more obese, had higher Acute Physiology and Chronic Health Evaluation (APACHE)-IV score, and ICU admission BGL. In comparison with nondiabetics, pre-existing DM was associated with lower ICU mortality (OR: 0.846, 95%CI: 0.791-0.905). In multivariable logistic regression and Cox proportional hazard analyses, pre-existing DM was associated with decreased odds of ICU mortality in hyperglycemic patients (>163 mg/dL), higher APACHE IV score (>67), middle to old age (45-75 years), sepsis and morbid obesity (BMI>35 kg/m2). Also, in comparison with nondiabetics, pre-existing DM was associated with lower mortality among those with higher mean BGL (>128 mg/dL), and higher mortality in lower mean BGL (<107 mg/dL). Conclusions: In comparison with nondiabetics, pre-existing DM is associated with a lower adjusted ICU mortality. This association is stronger in DM patients with hyperglycemia, obesity, sepsis, middle to old age, and higher APACHE IV score.

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Section: Discussionmentioning

confidence: 94%

Diabetes mellitus is associated with lower mortality in intensive care unit: a multicenter historical cohort study

Hu¹,

Hu²,

Wang³

et al. 2020

Preprint

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“…RBG interferes with blood flow in the culprit vessel and is linearly correlated with the TIMI blood flow index [23]. Some studies have indicated that RBG on admission is closely related to mortality in nondiabetic patients [24].…”

Section: Discussionmentioning

confidence: 99%

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

Qin

Yan

et al. 2019

BioMed Research International

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Objective To examine the relationship between admission random blood glucose (RBG), fasting blood glucose (FBG), and Gensini score in patients with acute myocardial infarction (AMI) to clarify the effects of RBG and FBG on the severity of coronary artery disease. Method A total of 958 consecutive AMI patients who underwent emergency coronary angiography at the Cardiology Department of Zhongda Hospital (affiliated with Southeast University) were enrolled in this study from January 1, 2016, to December 31, 2018. The Gensini score of each patient was calculated according to the results of coronary angiography. The RBG, FBG, baseline data, hematological indexes, echocardiography parameters, coronary angiography data, and the use of intra-aortic balloon pump (IABP) were recorded. Patients with an RBG level >11.1 mmol/L were classified into the stress hyperglycemia group, and those with an FBG level >7.0 mmol/L were classified into the elevated FBG group. The Gensini scores in the stress hyperglycemia and elevated FBG groups were compared to those in the control group, and correlations between the RBG and FBG levels and the Gensini scores of AMI patients were evaluated. Independent risk factors for the Gensini score were analyzed by multiple linear and multiple logistic regression analyses. Results The Gensini scores of the stress hyperglycemia group and the elevated FBG group were higher than those of the control group. RBG and FBG were positively correlated with the Gensini score, and there were significant differences between RBG and FBG in different Gensini score groups. After adjusting for confounding factors, multiple linear regression analysis showed that sex, diabetes, estimated glomerular filtration rate (eGFR), and FBG were independent risk factors for the Gensini score. Multiple logistic regression analysis showed that age and FBG were independent risk factors in group 2 compared to group 1, eGFR and FBG were independent risk factors in group 3, and eGFR and FBG were independent risk factors in group 4. Diabetes and RBG were not independent risk factors for the Gensini score. Conclusion The Gensini scores of patients in the stress hyperglycemia group and the elevated FBG group were significantly higher than those in the control group. RBG and FBG were positively correlated with the Gensini score in AMI patients, and FBG was an independent risk factor for the Gensini score in AMI patients.

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“…Our results are in line with studies investigating the prognostic value of ABG on intracerebral hemorrhage, myocardial infarction, and other critical conditions. [ 1 ] The likely explanations for this are as follows: first, higher ABG in non-diabetes, usually defined as stress hyperglycemia, tends to occur in patients with critical illness. Second, diabetic patients with long-term exposure to increased glucose may have reduced the adverse effects of hyperglycemia on metabolism.…”

mentioning

confidence: 99%

Prognostic value of admission hyperglycemia on outcomes of thrombolysis in ischemic stroke patients with or without diabetes

Fang

Pan

Wang

et al. 2020

Chinese Medical Journal

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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

Cited by 6 publications

References 23 publications

Diabetes mellitus is associated with lower mortality in intensive care unit: a multicenter historical cohort study

Diabetes mellitus is associated with lower mortality in intensive care unit: a multicenter historical cohort study

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

Prognostic value of admission hyperglycemia on outcomes of thrombolysis in ischemic stroke patients with or without diabetes

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