title: Relationship between glycated hemoglobin, Intensive Care Unit admission blood sugar and glucose control with ICU mortality in critically ill patients.
abstract: OBJECTIVE
  The association between hyperglycemia and mortality is believed to be influenced by the presence of diabetes mellitus (DM). In this study, we evaluated the effect of preexisting hyperglycemia on the association between acute blood glucose management and mortality in critically ill patients. The primary objective of the study was the relationship between HbA1c and mortality in critically ill patients. Secondary objectives of the study were relationship between Intensive Care Unit (ICU) admission blood glucose and glucose control during ICU stay with mortality in critically ill patients.
  
  
  METHODS
  Five hundred patients admitted to two ICUs were enrolled. Blood sugar and hemoglobin A1c (HbA1c) concentrations on ICU admission were measured. Age, sex, history of DM, comorbidities, Acute Physiology and Chronic Health Evaluation II score, sequential organ failure assessment score, hypoglycemic episodes, drug history, mortality, and development of acute kidney injury and liver failure were noted for all patients.
  
  
  RESULTS
  Without considering the history of diabetes, nonsurvivors had significantly higher HbA1c values compared to survivors (7.25 ± 1.87 vs. 6.05 ± 1.22, respectively, P < 0.001). Blood glucose levels in ICU admission showed a significant correlation with risk of death (P < 0.006, confidence interval [CI]: 1.004-1.02, relative risk [RR]: 1.01). Logistic regression analysis revealed that HbA1c increased the risk of death; with each increase in HbA1c level, the risk of death doubled. However, this relationship was not statistically significant (P: 0.161, CI: 0.933-1.58, RR: 1.2).
  
  
  CONCLUSIONS
  Acute hyperglycemia significantly affects mortality in the critically ill patients; this relation is also influenced by chronic hyperglycemia.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ata
authors.initials: A
authors.lastname: Mahmoodpoor
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Hamishehkar
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Shadvar
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Tehran University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammadtaghi
authors.initials: M
authors.lastname: Beigmohammadi
authors.affiliation: Department of Anesthesiology, Saudi German Hospital, Dubai, UAE.
authors.forename: Afshin
authors.initials: A
authors.lastname: Iranpour
authors.affiliation: Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sarvin
authors.initials: S
authors.lastname: Sanaie
keywords: Blood sugar; critically ill patients; glucose control; hemoglobin A1c; mortality