tailieunhanh - Báo cáo y học: "Mean glucose during ICU admission is related to mortality by a U-shaped curve in surgical and medical patients: a retrospective cohort study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Mean glucose during ICU admission is related to mortality by a U-shaped curve in surgical and medical patients: a retrospective cohort study. | Siegelaar et al. Critical Care 2010 14 R224 http content 14 6 R224 KS CRITICAL CARE RESEARCH Open Access Mean glucose during ICU admission is related to mortality by a U-shaped curve in surgical and medical patients a retrospective cohort study 1 1 2 2 Sarah E Siegelaar Jeroen Hermanides Heleen M Oudemans-van Straaten Peter HJ van der Voort Robert J Bosman2 Durk F Zandstra2 J Hans DeVries1 Abstract Introduction Lowering of hyperglycemia in the intensive care unit ICU is widely practiced. We investigated in which way glucose regulation defined as mean glucose concentration during admission is associated with ICU mortality in a medical and a surgical cohort. Methods Retrospective database cohort study including patients admitted between January 2004 and December 2007 in a 20-bed medical surgical ICU in a teaching hospital. Hyperglycemia was treated using a computerized algorithm targeting for glucose levels of mmol l. Five thousand eight hundred twenty-eight patients were eligible for analyses of whom 1 339 patients had a medical and 4 489 had a surgical admission diagnosis. Results The cohorts were subdivided in quintiles of increasing mean glucose. We examined the relation between these mean glucose strata and mortality. In both cohorts we observed the highest mortality in the lowest and highest strata. Logistic regression analysis adjusted for age sex Acute Physiology and Chronic Health Evaluation II APACHE II score admission duration and occurrence of severe hypoglycemia showed that in the medical cohort mean glucose levels mmol l and mmol l and in the surgical cohort mean glucose levels mmol l and mmol l were associated with significantly increased ICU mortality OR and respectively . Limitations of the study were its retrospective design and possible incomplete correction for severity of disease. Conclusions Mean overall glucose during ICU admission is related to mortality by a U-shaped curve in medical and .