title: Profile and long-term prognosis of glucose tight control in intensive care unit - patients: a cohort study.
abstract: OBJECTIVE
  Stress-induced hyperglycemia is frequent in critically ill patients and has been associated with increased mortality and morbidity (both in diabetic and non-diabetic patients). This study objective was to evaluate the profile and long-term prognosis of critically ill patients undergoing tight glucose-control.
  
  
  METHODS
  Prospective cohort. All patients admitted to the intensive care unit over 1-year were enrolled. We analyzed demographic data, therapeutic intervention, and short- (during the stay) and long-term (2 years after discharge) mortality. The patients were categorized in 2 groups: tight glucose control and non-tight glucose-control, based on the unit staff decision.
  
  
  RESULTS
  From the 603 enrolled patients, 102 (16.9%) underwent tight control (glucose <150 mg/dL) while 501 patients (83.1%) non-tight control. Patients in the TGC-group were more severely ill than those in the non-tight control group [APACHE II score (14 ± 3 versus 11 ± 4, P=0.04), SOFA (4.9 ± 3.2 versus 3.5 ± 3.4, P<0.001) and TISS-24h (25.7 ± 6.9 versus 21.1 ± 7.2, P< 0.001)]. The tight control group patients also had worse prognosis: [acute renal failure (51% versus 18.5%, P<0.001), critical illness neuropathy (16.7% versus 5.6%, P<0.001)] and increased mortality (during the ICU-stay [60.7% versus 17.7%, P<0.001] and within 2-years of the discharge [77.5% versus 23.4%; P<0.001]).
  
  
  CONCLUSIONS
  Critically ill patients needing tight glucose control during the unit stay have more severe disease and have worse short and long-term prognosis.
authors.affiliation: Complexo Hospitalar, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Márcia Inês
authors.initials: MI
authors.lastname: Boff
authors.affiliation: Unidade de Terapia Intensiva Central, Complexo Hospitalar, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Márcio Pereira
authors.initials: MP
authors.lastname: Hetzel
authors.affiliation: Unidade de Terapia Intensiva Central, Complexo Hospitalar, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Daniele Munaretto
authors.initials: DM
authors.lastname: Dallegrave
authors.affiliation: Unidade de Terapia Intensiva Central, Complexo Hospitalar, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Roselaine Pinheiro de
authors.initials: RP
authors.lastname: Oliveira
authors.affiliation: Universidade do Vale do Rio dos Sinos, Porto Alegre, RS, Brasil.
authors.forename: Claúdia da Rocha
authors.initials: Cda R
authors.lastname: Cabral
authors.affiliation: Unidade de Terapia Intensiva Central, Complexo Hospitalar, Santa Casa de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Cassiano
authors.initials: C
authors.lastname: Teixeira