OBJECTIVE: To determine whether mild or moderate hypoglycemia that occurs in critically ill patients is independently associated with an increased risk of death. PATIENTS AND METHODS: Of patients admitted to 2 hospital intensive care units (ICUs) in Melbourne and Sydney, Australia, from January 1, 2000, to October 14, 2004, we analyzed all those who had at least 1 episode of hypoglycemia (glucose concentration, <81 mg/dL). The independent association between hypoglycemia and outcome was statistically assessed. RESULTS: Of 4946 patients admitted to the ICUs, a cohort of 1109 had at least 1 episode of hypoglycemia (blood glucose level, <81 mg/dL). Of these 1109 patients (22.4% of all admissions to the intensive care unit), hospital mortality was 36.6% compared with 19.7% in the 3837 nonhypoglycemic control patients (P<.001). Even patients with a minimum blood glucose concentration between 72 and 81 mg/dL had a greater unadjusted mortality rate than did control patients (25.9% vs 19.7%; unadjusted odds ratio, 1.42; 95% confidence interval, 1.12-1.80; P=.004.) Mortality increased significantly with increasing severity of hypoglycemia (P<.001). After adjustment for insulin therapy, hypoglycemia was independently associated with increased risk of death, cardiovascular death, and death due to infectious disease. CONCLUSION: In critically ill patients, an association exists between even mild or moderate hypoglycemia and mortality. Even after adjustment for insulin therapy or timing of hypoglycemic episode, the more severe the hypoglycemia, the greater the risk of death.
OBJECTIVE: To determine whether mild or moderate hypoglycemia that occurs in critically illpatients is independently associated with an increased risk of death. PATIENTS AND METHODS: Of patients admitted to 2 hospital intensive care units (ICUs) in Melbourne and Sydney, Australia, from January 1, 2000, to October 14, 2004, we analyzed all those who had at least 1 episode of hypoglycemia (glucose concentration, <81 mg/dL). The independent association between hypoglycemia and outcome was statistically assessed. RESULTS: Of 4946 patients admitted to the ICUs, a cohort of 1109 had at least 1 episode of hypoglycemia (blood glucose level, <81 mg/dL). Of these 1109 patients (22.4% of all admissions to the intensive care unit), hospital mortality was 36.6% compared with 19.7% in the 3837 nonhypoglycemic control patients (P<.001). Even patients with a minimum blood glucose concentration between 72 and 81 mg/dL had a greater unadjusted mortality rate than did control patients (25.9% vs 19.7%; unadjusted odds ratio, 1.42; 95% confidence interval, 1.12-1.80; P=.004.) Mortality increased significantly with increasing severity of hypoglycemia (P<.001). After adjustment for insulin therapy, hypoglycemia was independently associated with increased risk of death, cardiovascular death, and death due to infectious disease. CONCLUSION: In critically illpatients, an association exists between even mild or moderate hypoglycemia and mortality. Even after adjustment for insulin therapy or timing of hypoglycemic episode, the more severe the hypoglycemia, the greater the risk of death.
Authors: Imogen Mitchell; Emma Knight; Jelena Gissane; Rohit Tamhane; Rao Kolli; I Anne Leditschke; Rinaldo Bellomo; Simon Finfer Journal: Crit Care Resusc Date: 2006-12 Impact factor: 2.159
Authors: Jean-Charles Preiser; Philippe Devos; Sergio Ruiz-Santana; Christian Mélot; Djillali Annane; Johan Groeneveld; Gaetano Iapichino; Xavier Leverve; Gérard Nitenberg; Pierre Singer; Jan Wernerman; Michael Joannidis; Adela Stecher; René Chioléro Journal: Intensive Care Med Date: 2009-07-28 Impact factor: 17.440
Authors: M Egi; H Morimatsu; Y Toda; T Matsusaki; S Suzuki; K Shimizu; T Iwasaki; M Takeuchi; R Bellomo; K Morita Journal: Int J Artif Organs Date: 2008-04 Impact factor: 1.595
Authors: R Phillip Dellinger; Mitchell M Levy; Jean M Carlet; Julian Bion; Margaret M Parker; Roman Jaeschke; Konrad Reinhart; Derek C Angus; Christian Brun-Buisson; Richard Beale; Thierry Calandra; Jean-Francois Dhainaut; Herwig Gerlach; Maurene Harvey; John J Marini; John Marshall; Marco Ranieri; Graham Ramsay; Jonathan Sevransky; B Taylor Thompson; Sean Townsend; Jeffrey S Vender; Janice L Zimmerman; Jean-Louis Vincent Journal: Crit Care Med Date: 2008-01 Impact factor: 7.598
Authors: Tuomas Oksanen; Markus B Skrifvars; Tero Varpula; Anne Kuitunen; Ville Pettilä; Jouni Nurmi; Maaret Castrén Journal: Intensive Care Med Date: 2007-10-11 Impact factor: 17.440
Authors: Frank M Brunkhorst; Christoph Engel; Frank Bloos; Andreas Meier-Hellmann; Max Ragaller; Norbert Weiler; Onnen Moerer; Matthias Gruendling; Michael Oppert; Stefan Grond; Derk Olthoff; Ulrich Jaschinski; Stefan John; Rolf Rossaint; Tobias Welte; Martin Schaefer; Peter Kern; Evelyn Kuhnt; Michael Kiehntopf; Christiane Hartog; Charles Natanson; Markus Loeffler; Konrad Reinhart Journal: N Engl J Med Date: 2008-01-10 Impact factor: 91.245
Authors: Moritoki Egi; James S Krinsley; Paula Maurer; Devendra N Amin; Tomoyuki Kanazawa; Shruti Ghandi; Kiyoshi Morita; Michael Bailey; Rinaldo Bellomo Journal: Intensive Care Med Date: 2016-02-03 Impact factor: 17.440