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蛛网膜下腔出血患者24小时静脉血糖均值与院内死亡率的关系:一项匹配队列研究。

Relationship between the mean of 24-h venous blood glucose and in-hospital mortality among patients with subarachnoid hemorrhage: A matched cohort study.

作者信息

Wang Jun-Hong, Li Hua, Yang Hong-Kuan, Chen Ru-Dong, Yu Jia-Sheng

机构信息

Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Neurol. 2022 Aug 2;13:904293. doi: 10.3389/fneur.2022.904293. eCollection 2022.

Abstract

OBJECTIVE

The aim of this study was to explore the correlation between the mean of 24-h venous blood glucose (BG) and in-hospital mortality and all-cause mortality (ACM) in patients with subarachnoid hemorrhage (SAH).

METHODS

Detailed clinical information was acquired from the Medical Information Mart for Intensive IV (MIMIC-IV) database. The best cutoff value of mean BG was calculated using the X-tile program. Univariate and multivariate logistic regressive analyses were utilized to analyze the prognosis significance of mean BG, and survival curves were drawn using the Kaplan-Meier (K-M) approach. To improve the reliability of results and balance the impact of underlying confounders, the 1:1 propensity score matching (PSM) approach was utilized.

RESULTS

An overall of 1,230 subjects were selected herein. The optimal cutoff value of the mean BG for in-hospital mortality was 152.25. In addition, 367 pairs of score-matched subjects were acquired after PSM analysis, and nearly all variables' differences were balanced. K-M analysis showed that patients with mean BG ≥ 152.25 mg/dl had significantly higher in-hospital, 3-month, and 6-month mortalities compared with patients with mean BG < 152.25 mg/dl ( < 0.001). The multivariable logistic regressive analyses revealed that patients with mean BG ≥ 152.25 mg/dl had significantly increased in-hospital mortality compared with patients with mean BG < 152.25 mg/dl after the adjustment for possible confounders (OR = 1.994, 95% CI: 1.321-3.012, = 0.001). Similar outcomes were discovered in the PSM cohort.

CONCLUSION

Our data suggested that mean BG was related to ACM of patients with SAH. More studies are needed to further analyze the role of the mean of 24-h venous BG in patients with SAH.

摘要

目的

本研究旨在探讨蛛网膜下腔出血(SAH)患者24小时静脉血糖(BG)均值与住院死亡率及全因死亡率(ACM)之间的相关性。

方法

从重症监护医学信息集市(MIMIC-IV)数据库中获取详细的临床信息。使用X-tile程序计算BG均值的最佳截断值。采用单因素和多因素逻辑回归分析来分析BG均值的预后意义,并使用Kaplan-Meier(K-M)方法绘制生存曲线。为提高结果的可靠性并平衡潜在混杂因素的影响,采用了1:1倾向评分匹配(PSM)方法。

结果

本研究共纳入1230名受试者。住院死亡率的BG均值最佳截断值为152.25。此外,PSM分析后获得了367对评分匹配的受试者,几乎所有变量的差异均达到平衡。K-M分析显示,BG均值≥152.25 mg/dl的患者与BG均值<152.25 mg/dl的患者相比,其住院、3个月和6个月死亡率显著更高(<0.001)。多因素逻辑回归分析显示,在对可能的混杂因素进行调整后,BG均值≥152.25 mg/dl的患者与BG均值<152.25 mg/dl的患者相比,住院死亡率显著增加(OR = 1.994,95%CI:1.321 - 3.012, = 0.001)。在PSM队列中也发现了类似的结果。

结论

我们的数据表明,BG均值与SAH患者的ACM相关。需要更多研究进一步分析24小时静脉BG均值在SAH患者中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef53/9379100/1f728dac7e1a/fneur-13-904293-g0001.jpg

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