Evidence map›Paper›PMID 18596625›Full record

ArticleCritical care medicine2008

Glucose variability and mortality in patients with sepsis.

Naeem A Ali, James M O'Brien, Kathleen Dungan, Gary Phillips, Clay B Marsh, Stanley Lemeshow, Alfred F Connors, Jean-Charles Preiser

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 171 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed, 7 pooled it
20.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

171 citing papers in PubMed, 7 syntheses or guidelines pooled it, 431 citations in OpenAlex.

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111 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Naeem A AliDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine and Center for Critical Care, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA. naeem.ali@osumc.edu
James M O'Brien
Kathleen Dungan
Gary Phillips
Clay B Marsh
Stanley Lemeshow
Alfred F Connors
Jean-Charles Preiser
The Ohio State University · USSociety of Critical Care Medicine · USUniversity of Liège · BE

Funding

Intensive glycemic control for congestive heart failure exacerbationK23DK080891 · NIDDK · OHIO STATE UNIVERSITY · PI DUNGAN, KATHLEEN MARIE · 2008 to 2012
$748k
TSP-1: A mediator of sepsis-induced lung injuryK23RR019544 · NCRR · OHIO STATE UNIVERSITY · PI ALI, NAEEM A · 2006 to 2010
$660k
NCRR NIH HHS K23 RR019544NIDDK NIH HHS K23 DK080891
6 · The paper itself

Abstract

objectiveTreatment and prevention of hyperglycemia has been advocated for subjects with sepsis. Glucose variability, rather than the glucose level, has also been shown to be an important factor associated with in-hospital mortality, in general, critically ill patients. Our objective was to determine the association between glucose variability and hospital mortality in septic patients and the expression of glucose variability that best reflects this risk.

designRetrospective, single-center cohort study.

settingAcademic, tertiary care hospital. PATIENTS: Adult subjects hospitalized for >1 day, with a diagnosis of sepsis were included.

interventionsNone. MEASUREMENTS: Glucose variability was calculated for all subjects as the average and standard deviation of glucose, the mean amplitude of glycemic excursions, and the glycemic lability index. Hospital mortality was the primary outcome variable. Logistic regression was used to determine the odds of hospital death in relation to measures of glucose variability after adjustment for important covariates. MAIN

resultsOf the methods used to measure glucose variability, the glycemic lability index had the best discrimination for mortality (area under the curve = 0.67, p < 0.001). After adjustment for confounders, including the number of organ failures and the occurrence of hypoglycemia, there was a significant interaction between glycemic lability index and average glucose level, and the odds of hospital mortality. Higher glycemic lability index was not independently associated with mortality among subjects with average glucose levels above the median for the cohort. However, subjects with increased glycemic lability index, but lower average glucose values had almost five-fold increased odds of hospital mortality (odds ratio = 4.73, 95% confidence interval = 2.6-8.7) compared with those with lower glycemic lability index.

conclusionsGlucose variability is independently associated with hospital mortality in septic patients. Strategies to reduce glucose variability should be studied to determine whether they improve the outcomes of septic patients.

Indexed as

Blood GlucoseGlycemic IndexHospital MortalityFemaleHumansLogistic ModelsMaleMedical Records Systems, ComputerizedMiddle AgedRetrospective StudiesSepsisBlood Glucose

Identifiers

PMID18596625
PMCPMC3176449
OpenAlexW2045596475

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.