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

The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.

Hypoglycemia and Outcome in Critically Ill Patients

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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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Metadata

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
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
2010-03
Volume
85
Issue
3
Pages
217-224
ISSN
0025-6196 (ISSN-L)
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
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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