Admission Blood Glucose Associated with In-Hospital Mortality in Critically III Non-Diabetic Patients with Heart Failure: A Retrospective Study

被引:0
作者
Chen, Yu [1 ]
Wang, YingZhi [1 ]
Chen, Fang [1 ]
Chen, CaiHua [1 ]
Dong, XinJiang [2 ]
机构
[1] Wenzhou Med Univ, Taizhou Hosp Zhejiang Prov, Dept Cardiac Surg, Wenzhou 317000, Zhejiang, Peoples R China
[2] Shanxi Cardiovasc Hosp, Dept Cardiol, Taiyuan 030024, Shanxi, Peoples R China
关键词
in-hospital mortality; admission blood glucose; heart failure; MIMIC-III; nonlinear relationship; U-shape; INTENSIVE INSULIN THERAPY; HYPERGLYCEMIA; HYPOGLYCEMIA; IMPACT; RISK; ICU;
D O I
10.31083/j.rcm2508275
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Heart failure (HF) is a primary public health issue associated with a high mortality rate. However, effective treatments still need to be developed. The optimal level of glycemic control in non-diabetic critically ill patients suffering from HF is uncertain. Therefore, this study examined the relationship between initial glucose levels and in-hospital mortality in critically ill non-diabetic patients with HF. Methods: A total of 1159 critically ill patients with HF were selected from the Medical Information Mart for Intensive Care-III (MIMIC-III) data resource and included in this study. The association between initial glucose levels and hospital mortality in seriously ill non-diabetic patients with HF was analyzed using smooth curve fittings and multivariable Cox regression. Stratified analyses were performed for age, gender, hypertension, atrial fibrillation, CHD with no MI (coronary heart disease with no myocardial infarction), renal failure, chronic obstructive pulmonary disease (COPD), estimated glomerular filtration rate (eGFR), and blood glucose concentrations. Results: The hospital mortality was identified as 14.9%. A multivariate Cox regression model, along with smooth curve fitting data, showed that the initial blood glucose demonstrated a U-shape relationship with hospitalized deaths in non-diabetic critically ill patients with HF. The turning point on the left side of the inflection point was HR 0.69, 95% CI 0.47-1.02, p = 0.068, and on the right side, HR 1.24, 95% CI 1.07-1.43, p = 0.003. Significant interactions existed for blood glucose concentrations (7-11 mmol/L) (p-value for interaction: 0.009). No other significant interactions were detected. Conclusions: This study demonstrated a U-shape correlation between initial blood glucose and hospital mortality in critically ill non-diabetic patients with HF. The optimal level of initial blood glucose for non-diabetic critically ill patients with HF was around 7 mmol/L.
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页数:8
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共 37 条
  • [31] Intensive insulin therapy in critically ill patients.
    Van den Berghe, G
    Wouters, P
    Weekers, F
    Verwaest, C
    Bruyninckx, F
    Schetz, M
    Vlasselaers, D
    Ferdinande, P
    Lauwers, P
    Bouillon, R
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (19) : 1359 - 1367
  • [32] Intensive insulin therapy in mixed medical/surgical intensive care units - Benefit versus harm
    Van den Berghe, Greet
    Wilmer, Alexander
    Milants, Ilse
    Wouters, Pieter J.
    Bouckaert, Bernard
    Bruyninckx, Frans
    Bouillon, Roger
    Schetz, Miet
    [J]. DIABETES, 2006, 55 (11) : 3151 - 3159
  • [33] The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies
    von Elm, Erik
    Altman, Douglas G.
    Egger, Matthias
    Pocock, Stuart J.
    Gotzsche, Peter C.
    Vandenbroucke, Jan P.
    [J]. INTERNATIONAL JOURNAL OF SURGERY, 2014, 12 (12) : 1495 - 1499
  • [34] Wu Zhixiong, 2022, J Intensive Med, V2, P131, DOI 10.1016/j.jointm.2022.06.001
  • [35] Variation in critical care services across North America and Western Europe
    Wunsch, Hannah
    Angus, Derek C.
    Harrison, David A.
    Collange, Olivier
    Fowler, Robert
    Hoste, Eric A. J.
    de Keizer, Nicolefte F.
    Kersten, Alexander
    Linde-Zwirble, Walter T.
    Sandiumenge, Alberto
    Rowan, Kathryn M.
    [J]. CRITICAL CARE MEDICINE, 2008, 36 (10) : 2787 - 2793
  • [36] Glycemic control, mortality, and hypoglycemia in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials
    Yamada, Tomohide
    Shojima, Nobuhiro
    Noma, Hisashi
    Yamauchi, Toshimasa
    Kadowaki, Takashi
    [J]. INTENSIVE CARE MEDICINE, 2017, 43 (01) : 1 - 15
  • [37] Severe Hypoglycemia and Risks of Vascular Events and Death.
    Zoungas, Sophia
    Patel, Anushka
    Chalmers, John
    de Galan, Bastiaan E.
    Li, Qiang
    Billot, Laurent
    Woodward, Mark
    Ninomiya, Toshiharu
    Neal, Bruce
    MacMahon, Stephen
    Grobbee, Diederick E.
    Kengne, Andre Pascal
    Marre, Michel
    Heller, Simon
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (15) : 1410 - 1418