Back to Search
Start Over
Hyperglycaemic index as a tool to assess glucose control: a retrospective study.
- Source :
-
Critical care (London, England) [Crit Care] 2004 Jun; Vol. 8 (3), pp. R122-7. Date of Electronic Publication: 2004 Mar 15. - Publication Year :
- 2004
-
Abstract
- Introduction: Critically ill patients may benefit from strict glucose control. An objective measure of hyperglycaemia for assessing glucose control in acutely ill patients should reflect the magnitude and duration of hyperglycaemia, should be independent of the number of measurements, and should not be falsely lowered by hypoglycaemic values. The time average of glucose values above the normal range meets these requirements.<br />Methods: A retrospective, single-centre study was performed at a 12-bed surgical intensive care unit. From 1990 through 2001 all patients over 15 years, staying at least 4 days, were included. Admission type, sex, age, Acute Physiology and Chronic Health Evaluation II score and outcome were recorded. The hyperglycaemic index (HGI) was defined as the area under the curve above the upper limit of normal (glucose level 6.0 mmol/l) divided by the total length of stay. HGI, admission glucose, mean morning glucose, mean glucose and maximal glucose were calculated for each patient. The relations between these measures and 30-day mortality were determined.<br />Results: In 1779 patients with a median stay in the intensive care unit of 10 days, the 30-day mortality was 17%. A total of 65,528 glucose values were analyzed. Median HGI was 0.9 mmol/l (interquartile range 0.3-2.1 mmol/l) in survivors versus 1.8 mmol/l (interquartile range 0.7-3.4 mmol/l) in nonsurvivors (P < 0.001). The area under the receiver operator characteristic curve was 0.64 for HGI, as compared with 0.61 and 0.62 for mean morning glucose and mean glucose. HGI was the only significant glucose measure in binary logistic regression.<br />Conclusion: HGI exhibited a better relation with outcome than other glucose indices. HGI is a useful measure of glucose control in critically ill patients.
- Subjects :
- APACHE
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers blood
Female
Hospitals, Teaching
Humans
Hyperglycemia blood
Hyperglycemia physiopathology
Intensive Care Units
Male
Middle Aged
Netherlands
Patient Admission
Prognosis
Reference Values
Retrospective Studies
Survival Analysis
Blood Glucose analysis
Critical Care standards
Critical Illness mortality
Hyperglycemia diagnosis
Outcome Assessment, Health Care
Subjects
Details
- Language :
- English
- ISSN :
- 1466-609X
- Volume :
- 8
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Critical care (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 15153239
- Full Text :
- https://doi.org/10.1186/cc2840