Mean amplitude of glycemic excursion and mortality in critically ill patients: A retrospective analysis using the MIMIC ‐ IV database
Authors' conclusion
MAGE exhibits effective predictive value for mortality in ICU patients, with distinct thresholds for diabetic and non-diabetic populations. These findings underscore the importance of tailored GV management strategies in critical care settings and support the adoption of MAGE as a standardised metric for GV assessment in ICU settings.
Study context
- Population
- Critically ill adults with intensive care unit (ICU) stays exceeding 24 h, MIMIC-IV database
- Participants
- 13,852 adults
- Exposure
- Mean Amplitude of Glycemic Excursion (MAGE) quartiles
- Outcome
- Mortality (ICU, in-hospital and 28-day)
Methodological detailsMIMIC-IV database, multivariable-adjusted
- MIMIC-IV database
- Multivariable-adjusted
Main finding
As reported in the abstract
ICU mortality, highest MAGE quartile: HR
3.59
95% CI 2.99–4.31
In-hospital mortality, highest MAGE quartile: HR
3.43
95% CI 2.92–4.02
28-day mortality, highest MAGE quartile: HR
2.04
95% CI 1.47–2.82
Observational data: associations, not effects.
Further findings
MAGE and mortality by diabetes status
- Non-diabetic patients: HR
- 3.36 (95% CI 2.90-3.89)
- Diabetic patients: HR
- 1.59 (95% CI 1.33-1.91)
Optimal MAGE thresholds (restricted cubic spline)
- Overall population
- 44.28 mg/dL
- Diabetic patients
- 58.97 mg/dL
- Non-diabetic patients
- 17.11 and 37.72 mg/dL
Predictive performance of MAGE for all-cause mortality
- AUC
- 0.6286 (95% CI 0.6171-0.6400)
- Adding MAGE to SAPS II and SOFA: Net reclassification improvement (NRI)
- 0.238
- Adding MAGE to SAPS II and SOFA: Integrated discrimination improvement (IDI)
- 0.008
Original publication
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