The Glycemic Ratio Is Strongly and Independently Associated With Mortality in the Critically Ill
Authors' conclusion
The GR provided new insight into malglycemia that was not apparent using mBG, or an admission value. Mortality was associated with acute change from preadmission glycemia (GR). Further assessment of the impact of GR deviations from the nadir in mortality at GR 0.80 to 0.99, as both relative hypo- and hyperglycemia, and as duration of exposure and intensity, may further define the multifaceted nature of malglycemia.
Study context
- Population
- Adult medical-surgical intensive care units (ICU) patients with ≥4 blood glucose (BGs), hemoglobin (Hgb) and hemoglobin A1c (HbA1c)
- Participants
- 4,790 patients
- Exposure
- Glycemic Ratio and mean ICU BG vs mortality
- Outcome
- Mortality
Methodological detailssingle adult medical-surgical ICU
- Single adult medical-surgical ICU
Main finding
As reported in the abstract
Glycemic Ratio (GR) associated with mortality in adjusted analysis, OR
2.61 (1.48-4.62), P = .0012 (95% CI)
mBG not associated with mortality in adjusted analysis, OR
1.004 (1.000-1.009), P = .059 (95% CI)
Observational data: associations, not effects.
Further findings
mBG and mortality
- mBG linear relationship with mortality at lower HbA1c, diminished for HbA1c >6.5%, dependent on preadmission glycemia
Single admission BG value and mortality
- Not independently associated with mortality
Original publication
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