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Hyperglycaemic index as a tool to assess glucose control: a retrospective study

INTRODUCTION: Critically ill patients may benefit from strict glucose control. An objective measure of hyperglycaemia for assessing glucose control in acutely ill patients should reflect the magnitude and duration of hyperglycaemia, should be independent of the number of measurements, and should not...

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Autores principales: Vogelzang, Mathijs, van der Horst, Iwan CC, Nijsten, Maarten WN
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC468891/
https://www.ncbi.nlm.nih.gov/pubmed/15153239
http://dx.doi.org/10.1186/cc2840
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author Vogelzang, Mathijs
van der Horst, Iwan CC
Nijsten, Maarten WN
author_facet Vogelzang, Mathijs
van der Horst, Iwan CC
Nijsten, Maarten WN
author_sort Vogelzang, Mathijs
collection PubMed
description INTRODUCTION: Critically ill patients may benefit from strict glucose control. An objective measure of hyperglycaemia for assessing glucose control in acutely ill patients should reflect the magnitude and duration of hyperglycaemia, should be independent of the number of measurements, and should not be falsely lowered by hypoglycaemic values. The time average of glucose values above the normal range meets these requirements. METHODS: A retrospective, single-centre study was performed at a 12-bed surgical intensive care unit. From 1990 through 2001 all patients over 15 years, staying at least 4 days, were included. Admission type, sex, age, Acute Physiology and Chronic Health Evaluation II score and outcome were recorded. The hyperglycaemic index (HGI) was defined as the area under the curve above the upper limit of normal (glucose level 6.0 mmol/l) divided by the total length of stay. HGI, admission glucose, mean morning glucose, mean glucose and maximal glucose were calculated for each patient. The relations between these measures and 30-day mortality were determined. RESULTS: In 1779 patients with a median stay in the intensive care unit of 10 days, the 30-day mortality was 17%. A total of 65,528 glucose values were analyzed. Median HGI was 0.9 mmol/l (interquartile range 0.3–2.1 mmol/l) in survivors versus 1.8 mmol/l (interquartile range 0.7–3.4 mmol/l) in nonsurvivors (P < 0.001). The area under the receiver operator characteristic curve was 0.64 for HGI, as compared with 0.61 and 0.62 for mean morning glucose and mean glucose. HGI was the only significant glucose measure in binary logistic regression. CONCLUSION: HGI exhibited a better relation with outcome than other glucose indices. HGI is a useful measure of glucose control in critically ill patients.
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spelling pubmed-4688912004-07-16 Hyperglycaemic index as a tool to assess glucose control: a retrospective study Vogelzang, Mathijs van der Horst, Iwan CC Nijsten, Maarten WN Crit Care Research INTRODUCTION: Critically ill patients may benefit from strict glucose control. An objective measure of hyperglycaemia for assessing glucose control in acutely ill patients should reflect the magnitude and duration of hyperglycaemia, should be independent of the number of measurements, and should not be falsely lowered by hypoglycaemic values. The time average of glucose values above the normal range meets these requirements. METHODS: A retrospective, single-centre study was performed at a 12-bed surgical intensive care unit. From 1990 through 2001 all patients over 15 years, staying at least 4 days, were included. Admission type, sex, age, Acute Physiology and Chronic Health Evaluation II score and outcome were recorded. The hyperglycaemic index (HGI) was defined as the area under the curve above the upper limit of normal (glucose level 6.0 mmol/l) divided by the total length of stay. HGI, admission glucose, mean morning glucose, mean glucose and maximal glucose were calculated for each patient. The relations between these measures and 30-day mortality were determined. RESULTS: In 1779 patients with a median stay in the intensive care unit of 10 days, the 30-day mortality was 17%. A total of 65,528 glucose values were analyzed. Median HGI was 0.9 mmol/l (interquartile range 0.3–2.1 mmol/l) in survivors versus 1.8 mmol/l (interquartile range 0.7–3.4 mmol/l) in nonsurvivors (P < 0.001). The area under the receiver operator characteristic curve was 0.64 for HGI, as compared with 0.61 and 0.62 for mean morning glucose and mean glucose. HGI was the only significant glucose measure in binary logistic regression. CONCLUSION: HGI exhibited a better relation with outcome than other glucose indices. HGI is a useful measure of glucose control in critically ill patients. BioMed Central 2004 2004-03-15 /pmc/articles/PMC468891/ /pubmed/15153239 http://dx.doi.org/10.1186/cc2840 Text en Copyright © 2004 Vogelzang et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research
Vogelzang, Mathijs
van der Horst, Iwan CC
Nijsten, Maarten WN
Hyperglycaemic index as a tool to assess glucose control: a retrospective study
title Hyperglycaemic index as a tool to assess glucose control: a retrospective study
title_full Hyperglycaemic index as a tool to assess glucose control: a retrospective study
title_fullStr Hyperglycaemic index as a tool to assess glucose control: a retrospective study
title_full_unstemmed Hyperglycaemic index as a tool to assess glucose control: a retrospective study
title_short Hyperglycaemic index as a tool to assess glucose control: a retrospective study
title_sort hyperglycaemic index as a tool to assess glucose control: a retrospective study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC468891/
https://www.ncbi.nlm.nih.gov/pubmed/15153239
http://dx.doi.org/10.1186/cc2840
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