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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2005 November;71(11):717-25

language: English, Italian

Correlation between hyperglycemia and mortality in a medical and surgical intensive care unit

Gabbanelli V., Pantanetti S., Donati A., Principi T., Pelaia P.

Department of Medical and Surgical Emergencies Polytechnic University of Marche, Ancona, Italy


Aim. The aim of this study was to assess the correlation between hyperglycemia and mortality in a group of patients admitted to a medical and surgical ICU and to evaluate if the association between hyperglycemia and reason of ICU admission significantly worsens patients’ outcomes.
Methods. A retrospective clinical study was conducted in the ICU of a University Hospital. Four-hundred and twelve adult patients admitted to our ICU were enrolled. The blood glucose level was measured at the time of admission and daily at 2-4 h intervals. When the glucose level exceeded 180 mg/dL, an insulin bolus or a continuous infusion were performed to maintain the glucose level at or below 180-200 mg/dL.
Results. Analysing the mean blood glucose levels of patients with the receiver operating characteristic (ROC) curve, it resulted that the blood glucose level of 141.7 mg/dL had higher sensitivity (76%) and specificity (56.5%) to discriminate the probability of death. In other words, in patients in whom the mean blood glucose levels were greater than 141.7 mg/dL, the probability of death was higher (26.62%) than in the group of patients in whom a strict blood glucose control was maintained (13.55%) (P = 0.0017).
Conclusion. A strict blood glucose control seems to be crucial, even in a medical and surgical ICU. The need for intensive insulin therapy, even by means of continuous infusion of insulin, to obtain the normalization of blood glucose levels, appears essential.

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