Prognostic value of glycaemic variability for mortality in cardiogenic shock patients: a retrospective cohort study
Authors' conclusion
GV is a significant predictor of 30-day, 90-day, and 360-day all-cause mortality after ICU admission in non-diabetic CS patients. GV may serve as a valuable marker for risk stratification and guiding subsequent interventions in CS non-diabetic patients, which emphasized the importance of stable control of blood glucose.
Study context
- Population
- Patients with cardiogenic shock (CS) admitted to ICU, MIMIC-IV 3.0, 2008–2022; mean (SD) age 69.81 (14.29) years, 60.51% maleMIMIC-IV cohort
- Participants
- 2,335 patients
- Exposure
- Glycaemic variability (GV) quartiles
- Outcome
- All-cause mortality after ICU admission
- Follow-up
- 30, 90 and 360 days
Methodological detailsMIMIC-IV 3.0 database, external validation in eICU 2.0 database
- MIMIC-IV 3.0 database
- External validation in eICU 2.0 database
Main finding
As reported in the abstract
All-cause mortality
Q4 vs Q1Hazard ratio (95% CI)P value
30-day; multivariate Cox
1.260(1.031–1.540)
P = 0.02490-day; multivariate Cox
1.235(1.028–1.485)
P = 0.024360-day; multivariate Cox
1.323(1.115–1.570)
P = 0.001- 30-day mortality, Q1 vs Q2 vs Q3 vs Q4 (p < 0.001)
- 31.7% vs. 36.1% vs. 37.8% vs. 47.3%
- 90-day mortality, Q1 vs Q2 vs Q3 vs Q4 (p < 0.001)
- 38.8% vs. 43.0% vs. 48.5% vs. 53.9%
- 360-day mortality, Q1 vs Q2 vs Q3 vs Q4 (p < 0.001)
- 44.6% vs. 49.8% vs. 57.3% vs. 63.0%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| External validation (eICU 2.0): in-ICU and in-hospital all-cause mortalityQ4vs Q1in-ICU mortality | 2.611 (1.613–4.226) | P < 0.001 | |
| External validation (eICU 2.0): in-ICU and in-hospital all-cause mortalityQ4vs Q1In-hospital mortality | 2.104 (1.396–3.171) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
- External validation (eICU 2.0): in-ICU and in-hospital all-cause mortality — eICU 2.0 validation cohort
- 1100 CS patients
Subgroups by diabetes status
- Effect of GV consistent across most subgroups except diabetes; significantly elevated mortality risk without diabetes, no significant association with diabetes
Original publication
Prognostic value of glycaemic variability for mortality in cardiogenic shock patients: a retrospective cohort study. Cardiovasc Diabetol. Published 10 October 2025. doi:10.
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