Lionte Catalina, Bologa Cristina, Agafiti Inga, Sorodoc Victorita, Petris Ovidiu Rusalim, Jaba Elisabeta, Sorodoc Laurentiu
Internal Medicine and Clinical Toxicology Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
2nd Internal Medicine Clinic, "Sf. Spiridon" Emergency Clinic County Hospital, 700111 Iasi, Romania.
Diagnostics (Basel). 2021 Feb 20;11(2):361. doi: 10.3390/diagnostics11020361.
The prognostic value of multiple glycemic parameters in poisoned patients was never assessed. We aim to explore the effects of glucose variability on short-term outcomes in nondiabetic and diabetic patients acutely poisoned with undifferentiated xenobiotics. We performed a prospective observational study in a tertiary center for toxicology in northeastern Romania. Over the course of 3 years, we included 1076 adults, older than 18 years, admitted for acute poisoning with a xenobiotic. The mortality rate was 4.1%. The admission blood glucose level (BGL) predicted mortality (OR 1.015, 95% CI 1.011-1.019, < 0.001) and complications (OR 1.005, 95% CI 1.001-1.009, 0.02). The mean glucose level (MGL) after admission (OR 1.007, 95% CI 1.000-1.013, 0.034) and coefficient of glucose variability (CV) were predictive for complications (OR 40.58, 95% CI 1.35-1220.52, 0.033), using the same multivariable model. The receiver operating characteristic curve (ROC) analysis revealed that BGL had good predictive value for in-hospital mortality (area under the curve (AUC) = 0.744, 95% CI = 0.648-0.841, < 0.001), and complications (AUC = 0.618, 95% CI = 0.584-0.653, < 0.001). In patients acutely poisoned with xenobiotics, the BGL, MGL and CV can be useful as mortality and short-outcome predictors.
从未评估过多种血糖参数对中毒患者的预后价值。我们旨在探讨血糖变异性对急性中毒未分化外源性物质的非糖尿病和糖尿病患者短期结局的影响。我们在罗马尼亚东北部的一家三级毒理学中心进行了一项前瞻性观察性研究。在3年的时间里，我们纳入了1076名18岁以上因外源性物质急性中毒入院的成年人。死亡率为4.1%。入院血糖水平（BGL）可预测死亡率（OR 1.015，95% CI 1.011 - 1.019，< 0.001）和并发症（OR 1.005，95% CI 1.001 - 1.009，P = 0.02）。入院后平均血糖水平（MGL）（OR 1.007，95% CI 1.000 - 1.013，P = 0.034）和血糖变异系数（CV）使用相同的多变量模型可预测并发症（OR 40.58，95% CI 1.35 - 1220.52，P = 0.033）。受试者工作特征曲线（ROC）分析显示，BGL对院内死亡率具有良好的预测价值（曲线下面积（AUC）= 0.744，95% CI = 0.648 - 0.841，< 0.001），对并发症也有预测价值（AUC = 0.618，95% CI = 0.584 - 0.653，< 0.001）。在外源性物质急性中毒的患者中，BGL、MGL和CV可作为死亡率和短期结局的预测指标。
