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急性呼吸衰竭患者 24 小时静脉血糖变异性与死亡率的关系。

Relationship between 24-h venous blood glucose variation and mortality among patients with acute respiratory failure.

机构信息

Department of Critical Care Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.

Department of Emergency Medicine, Xi Yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.

出版信息

Sci Rep. 2021 Apr 8;11(1):7747. doi: 10.1038/s41598-021-87409-2.

DOI:10.1038/s41598-021-87409-2
PMID:33833344
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8032795/
Abstract

Evidence indicates that glucose variation (GV) plays an important role in mortality of critically ill patients. We aimed to investigate the relationship between the coefficient of variation of 24-h venous blood glucose (24-hVBGCV) and mortality among patients with acute respiratory failure. The records of 1625 patients in the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) database were extracted. The 24-hVBGCV was calculated as the ratio of the standard deviation (SD) to the mean venous blood glucose level, expressed as a percentage. The outcomes included ICU mortality and in-hospital mortality. Participants were divided into three subgroups based on tertiles of 24-hVBGCV. Multivariable logistic regression models were used to evaluate the relationship between 24-hVBGCV and mortality. Sensitivity analyses were also performed in groups of patients with and without diabetes mellitus. Taking the lowest tertile as a reference, after adjustment for all the covariates, the highest tertile was significantly associated with ICU mortality [odds ratio (OR), 1.353; 95% confidence interval (CI), 1.018-1.797] and in-hospital mortality (OR, 1.319; 95% CI, 1.003-1.735), especially in the population without diabetes. The 24-hVBGCV may be associated with ICU and in-hospital mortality in patients with acute respiratory failure in the ICU, especially in those without diabetes.

摘要

证据表明,血糖变异(GV)在危重症患者的死亡率中起着重要作用。我们旨在研究急性呼吸衰竭患者的 24 小时静脉血糖变异系数(24-hVBGCV)与死亡率之间的关系。从 Multiparameter Intelligent Monitoring in Intensive Care II(MIMIC II)数据库中提取了 1625 名患者的记录。24-hVBGCV 计算为标准差(SD)与静脉血糖水平均值的比值,以百分比表示。结果包括 ICU 死亡率和住院死亡率。参与者根据 24-hVBGCV 的三分位数分为三组。使用多变量逻辑回归模型评估 24-hVBGCV 与死亡率之间的关系。还在有和没有糖尿病的患者组中进行了敏感性分析。以最低三分位数作为参考,在调整所有协变量后,最高三分位数与 ICU 死亡率[比值比(OR),1.353;95%置信区间(CI),1.018-1.797]和住院死亡率(OR,1.319;95%CI,1.003-1.735)显著相关,尤其是在没有糖尿病的人群中。24-hVBGCV 可能与 ICU 和急性呼吸衰竭患者的住院死亡率相关,尤其是在没有糖尿病的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/638b/8032795/9fcbfe5594e3/41598_2021_87409_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/638b/8032795/9fcbfe5594e3/41598_2021_87409_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/638b/8032795/9fcbfe5594e3/41598_2021_87409_Fig1_HTML.jpg

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本文引用的文献

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