Photo Credit: Alena Butusava

The following is a summary of “Association of Relative Dysglycemia With Hospital Mortality in Critically Ill Patients: A Retrospective Study,” published in the April 2024 issue of Critical Care by Okazaki et al.

For patients who are critically ill, relative dysglycemia has emerged as a distinct clinical condition, though studies on its impact remain limited.

Researchers conducted a retrospective study examining the association between blood sugar fluctuations (both high and low) within the first 24 hours of ICU admission and in-hospital mortality to identify potential thresholds for these effects.

They urgently admitted adults who were critically ill at an urban tertiary hospital ICU from January 2016 to March 2022.

The results showed that the maximum and minimum glycemic ratio (GR) were calculated as the highest and lowest blood glucose values within the first 24 hours after ICU admission, divided by the average glucose derived from hemoglobin A1c, 1,700 patients, with an in-hospital mortality rate of 16.9%. Non-survivors had a higher maximum GR but no significant difference in minimum GR. Within the first 24 hours after ICU admission, the maximum GR showed a J-shaped relationship with in-hospital mortality, peaking at approximately 1.12 and a threshold of 1.25 for an increased adjusted odds ratio for mortality. The minimum GR within the first 24 hours after ICU admission displayed a U-shaped correlation with in-hospital mortality, with a nadir at around 0.81 and a lower threshold of 0.69 for an increased adjusted odds ratio for mortality.

Investigators concluded that relative dysglycemia within the first 24 hours of ICU admission was associated with increased hospital mortality.

Source:journals.lww.com/ccmjournal/abstract/9900/association_of_relative_dysglycemia_with_hospital.329.aspx