Mean glucose level is not an independent risk factor for mortality in mixed ICU patients.
OBJECTIVE
To find out if there is an association between hyperglycaemia and mortality in mixed ICU patients.


METHODS
Retrospective cohort study over a 2-year period at the medical ICU of a university hospital.


METHODS
Admission glucose, maximum and mean glucose, length of stay, mortality, insulin therapy and Apache-II score.


RESULTS
In 1085 consecutive patients, ICU- and hospital mortality were 20 and 25%, respectively. The total number of blood glucose measurements was 10.012. Admission glucose was 7.9 +/- 4.5 mmol/l (mean +/- SD), mean glucose 7.5 +/- 2.9 and maximum glucose 10.0 +/- 5.4 mmol/l. Median ICU length of stay (LOS) was 3.0 days (range 2.0-6.0 days, IQR), and hospital LOS was 16 days (range 7-32 days). In 28% of patients insulin treatment was started. Median Apache-II score was 13. 68% of patients were mechanically ventilated. Univariate analysis showed an association with ICU mortality for mean glucose (non-survivors 8.6 +/- 4.3 vs 7.2 +/- 2.4 survivors), maximum glucose (11.7 +/- 5.9 vs 9.6 +/- 5.2, non-survivors vs survivors, respectively), use of insulin (mortality 29 vs 17% in patients not using insulin) and age (61 vs 55.7 years). Gender and a history of diabetes mellitus were not associated with mortality. In a multivariate model, the Apache-II score was the only variable associated with mortality independent of other variables, including mean blood glucose.


CONCLUSIONS
In this retrospective study mean glucose level was not an independent risk factor for mortality in mixed ICU patients.
University Medical Centre Groningen, Intensive and Respiratory Care Unit (ICB), 30.001, 9700 RB, Groningen, The Netherlands. j.j.m.ligtenberg@int.umcg.nl
Jack J M
JJ
Ligtenberg
Sofie
S
Meijering
Ymkje
Y
Stienstra
Iwan C C
IC
van der Horst
Mathijs
M
Vogelzang
Maarten W N
MW
Nijsten
Jaap E
JE
Tulleken
Jan G
JG
Zijlstra
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands; D012189:Retrospective Studies; D012307:Risk Factors
D001786:Blood Glucose