The Outcome of Glycemic Control in Critically Ill Septic Patients

Shahab, Lylla; Soufi, Shadi; Al-Hamad, Suzzanne; Shibli, Muhammad H.

doi:10.1378/chest.1116700

Cited by 1 publication

(3 citation statements)

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“…After screening titles and abstracts, 62 reports were potentially eligible. Finally, we included 10 studies, of which 7 were 5,6,11 –13,24,25 full texts and 3 were 26 –28 conference abstracts (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…We performed dose–response meta-analyses to fit for the potential nonlinear relationship between BG and mortality in patients with sepsis. All the 10 studies 5,6,11 –13,24 –28 were included in the dose–response meta-analyses, of which 9 reported 5,6,11,12,24 –28 unadjusted ORs and 4 studies 6,12,13,25 reported adjusted ORs. These 10 studies had various blood measurement and BG categories, and the glucose value ranged from 62 to 300 mg/dL (Additional file 4: Table S3).…”

Section: Resultsmentioning

confidence: 99%

“…However, available data were sufficient only for MBG. Four studies investigated the relationship between MBG level and mortality, 6,12,26,27 dose–response meta-analysis showed a U-shape relationship between MBG level and mortality, with MBG at about 145 mg/dL having the lowest hospital mortality (Additional file 7: Figure S2).…”

Section: Resultsmentioning

confidence: 99%

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Blood Glucose Levels and Mortality in Patients With Sepsis: Dose–Response Analysis of Observational Studies

Wang

Chen

Liu

et al. 2019

J Intensive Care Med

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Background: We undertook a systematic review and meta-analysis to investigate the relationship between blood glucose levels and mortality in patients with sepsis. Methods: Medline and EMBASE were searched from inception to April 8, 2018. Cohort studies or case–control studies reported the association between blood glucose and mortality in patients with sepsis were selected. Study characteristics, baseline characteristics, definition of hyperglycemia, and outcomes of interest were extracted. We performed a dose–response meta-analysis to assess the effect of blood glucose level on mortality. We also conducted meta-analysis for patients with or without diabetes separately. Results: Ten cohort studies involving 26 429 patients were included, of which 5 were prospective studies and 5 retrospective studies. Dose–response analysis showed that the effect of blood glucose on mortality may differ in patients with versus without diabetes. There was a U-shaped relationship for patients with diabetes and a J-shaped relationship for patients without diabetes, with blood glucose at 145 to 155 mg/dL corresponding to lowest mortality both in patients with and without diabetes. Conclusions: Current evidence suggested U-shaped relationship between blood glucose and mortality in all patients irrespective of their diabetes status. Diabetic patients with blood glucose below 145 mg/dL may have poorer prognosis compared to patients without established diabetes.

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