Cited by 432Hyperglycemia and glycemic control in critically ill and hospitalized patientsDiabetes Management and ResearchIntensive Care Unit Cognitive Disorders

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Hypoglycemia and Outcome in Critically Ill Patients

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Egi, Moritoki, Bellomo, Rinaldo, Stachowski, Edward, French, Craig J., Hart, Graeme K., Taori, Gopal, Hegarty, Colin, Bailey, Michael·2010·Mayo Clinic Proceedings

DOI 10.4065/mcp.2009.0394PMC PMC2843109

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Abstract

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.

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Authors: Egi, M., Bellomo, R., Stachowski, E., French, C. J., Hart, G. K., Taori, G., Hegarty, C., & Bailey, M.
Affiliations: Okayama University Hospital (JP)
Monash University (AU)
Westmead Hospital (AU)
Western Hospital (AU)
Austin Hospital (AU)
Corresponding author: Bellomo, Rinaldo
ORCID: Egi, Moritoki
Bellomo, Rinaldo
French, Craig J.
Hart, Graeme K.
Hegarty, Colin
Bailey, Michael
Venue: Mayo Clinic Proceedings
Publisher: Elsevier BV
Published: 2010-03
Volume: 85
Issue: 3
Pages: 217-224
ISSN: 0025-6196 (ISSN-L)
DOI: 10.4065/mcp.2009.0394
PMC: PMC2843109
OpenAlex: W1999231148
Cited by: 432
References: 45
Citations by year: 2026: 12 · 2025: 18 · 2024: 14 · 2023: 14 · 2022: 15 · 2021: 33 · 2020: 20 · 2019: 27 · 2018: 30 · 2017: 21 · 2016: 31 · 2015: 36 · 2014: 30 · 2013: 25 · 2012: 48
FWCI: 31.37
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Mayo Clinic Proceedings (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Keywords: hypoglycemia, critically ill patients, intensive care unit, mortality, insulin therapy, cardiovascular mortality, infectious disease mortality, blood glucose
MeSH terms: Blood Glucose, Cause of Death, Female, Follow-Up Studies, Humans, Hypoglycemia, Intensive Care Units, Male, Middle Aged, Morbidity, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index, Victoria, Survival Rate, Critical Illness, Hospital Mortality

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Hypoglycemia and Outcome in Critically Ill Patients

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