Association of glycemic variability with short and long-term mortality among critically ill patients with heart failure: Analysis of the MIMIC-IV database.

OBJECTIVE

High glycemic variability (GV) often indicates a poor prognosis. Our aim is to investigate the relationship between GV and short and long-term mortality in critically ill heart failure (HF) patients.

METHODS

We extracted data from the Medical Information Mart for Intensive Care IV database. The risks of in-hospital and 1-year mortality were calculated using Logistic and COX regression. In addition, mediation analysis was used to investigate the indirect effect of ventricular arrhythmias (VA) on in-hospital mortality.

RESULTS

Among 8,980 critically ill HF patients, the multifactorial regression analysis showed that high GV was associated with an increased risk of in-hospital and 1-year mortality (OR 1.69, 95 % CI 1.47-1.93; HR 1.12, 95 % CI 1.02-1.22). The Kaplan-Meier survival curve and restricted cubic spline plot also emphasized this association. Furthermore, the impact of GV on in-hospital mortality was partially mediated by VA (4.98%). And the increased risk of 1-year mortality associated with high GV was more significant in person with diabetes (p for interaction =0.018).

CONCLUSION

Our Study indicates that high GV may be an independent risk factor for short and long-term mortality in critically ill HF patients. Maintaining the stability of blood glucose can reduce adverse outcomes in critically ill HF patients.