Emergency Medical Center, Kagawa University Hospital, 1750-1 Ikenobe, Miki, Kita, Kagawa, 761-0793, Japan.
Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo, 651-0073, Japan.
Sci Rep. 2022 Jul 13;12(1):11864. doi: 10.1038/s41598-022-15795-2.
The aim of this single-center retrospective study was to investigate the association between the time in range (TIR) of relative normoglycemia (RN) and in-hospital mortality. We defined RN as measured blood glucose in the range of 70-140% of A1C-derived average glucose and absolute normoglycemia (AN) as 70-140 mg/dL. We conducted multivariate logistic regression analyses to examine the association between TIR of RN > 80% or TIR of AN > 80% up to 72 h after ICU admission and in-hospital mortality (Model 1 and Model 2, respectively). The discrimination of the models was assessed using the area under the receiver operating characteristic curve (AUROC). Among 328 patients, 35 died in hospital (11%). Model 1 showed that TIR of RN > 80% was associated with reduced in-hospital mortality (adjusted OR 0.16; 95% CI 0.06-0.43; P < 0. 001); however, Model 2 showed that the TIR of AN > 80% was not. The AUROC of Model 1 was significantly higher than that of Model 2 (0.84 [95% CI 0.77-0.90] vs. 0.79 [0.70-0.87], P = 0.008).Our findings provide a foundation for further studies exploring individualized glycemic management in ICUs.
本单中心回顾性研究旨在探讨相对正常血糖范围内时间（TIR）与住院期间死亡率之间的关系。我们将 RN 定义为血糖测量值在 A1C 衍生平均血糖的 70-140%范围内，绝对正常血糖（AN）定义为 70-140mg/dL。我们进行了多变量逻辑回归分析，以检查 ICU 入院后 72 小时内 RN>TIR80%或 AN>TIR80%与住院期间死亡率之间的关系（模型 1 和模型 2 分别）。使用受试者工作特征曲线下面积（AUROC）评估模型的区分度。在 328 名患者中，35 人在医院死亡（11%）。模型 1 显示，RN>TIR80%与降低住院期间死亡率相关（调整后的 OR 0.16；95%CI 0.06-0.43；P<0.001）；然而，模型 2 显示，AN>TIR80%则不然。模型 1 的 AUROC 明显高于模型 2（0.84[95%CI 0.77-0.90]vs.0.79[0.70-0.87]，P=0.008）。我们的研究结果为进一步研究 ICU 中的个体化血糖管理提供了基础。
