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Glucose control positively influences patient outcome: A retrospective study

par Penning, Sophie;Pretty, Christopher C.G.;Preiser, Jean-Charles ;Shaw, Geoffrey G.M.;Desaive, Thomas;Chase, James Geoffrey
Référence Journal of critical care, 30, 3, page (455-459)
Publication Publié, 2015-06

Article révisé par les pairs

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Résumé :

Objective: The goal of this research is to demonstrate that well-regulated glycemia is beneficial to patient outcome, regardless of how it is achieved. Methods: This analysis used data from 1701 patients from 2, independent studies. Glycemic outcome was measured using cumulative time in band (cTIB), calculated for 3 glycemic bands and for threshold values of t = 0.5, 0.6, 0.7, and 0.8. For each day of intensive care unit stay, patients were classified by cTIB, threshold, and hospital mortality, and odds of living (OL) and odds ratio were calculated. Results: The OL given cTIB ≥ t is higher than the OL given cTIB < t for all values of t, every day, for all 3 glycemic bands studied. The difference between the odds clearly increased over intensive care unit stay for t>. 0.6. Higher cTIB thresholds resulted in larger increases to odds ratio over time and were particularly significant for the 4.0 to 7.0 mmol/L glycemic band. Conclusion: Increased cTIB was associated with higher OL. These results suggest that effective glycemic control positively influences patient outcome, regardless of how the glycemic regulation is achieved. Blood glucose < 7.0 mmol/L is associated with a measurable increase in the odds of survival, if hypoglycemia is avoided.