Association of glycemic control parameters with clinical outcomes in chronic critical illness

Publication Date

2014

Journal Title

Endocr Pract

Abstract

OBJECTIVE: Chronic critical illness (CCI) is a term used to designate patients requiring prolonged mechanical ventilation and tracheostomy with associated poor outcomes. The present study assessed the impact of glycemic parameters on outcomes in a CCI population. METHODS: A retrospective case series was performed including 148 patients in The Mount Sinai Hospital Respiratory Care Unit (2009-2010). Utilizing a semi-parametric mixture model, trajectories for the daily mean blood glucose (BG), BG range, and hypoglycemia rate over time identified low- (n = 87) and high-risk (n = 61) hyperglycemia groups and low- (n = 90) and high-risk (n = 58) hypoglycemia groups. The cohort was also classified into diabetes (DM, n = 48), stress hyperglycemia (SH, n = 85), and normal glucose (n = 15) groups. RESULTS: Hospital- (28% vs. 13%, P = .0199) and 1-year mortality (66% vs. 46%, P = .0185) rates were significantly greater in the high- versus low-risk hyperglycemia groups, respectively. The hypoglycemia rate (/dL) was lower among ventilator-liberated patients compared to those who failed to liberate (0.092 vs. 0.130, P

Volume Number

20

Issue Number

9

Pages

884-93

Document Type

Article

EPub Date

2014/03/20

Status

Faculty

Facility

School of Medicine

Primary Department

Endocrinology, Diabetes, and Metabolism

PMID

24641919

DOI

10.4158/ep13324.or

Comments

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