ArticleCritical care (London, England)2010
Organ failure and tight glycemic control in the SPRINT study.
Article in Critical care (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glucose variability measures and their effect on mortality: a systematic review.Intensive care medicine · 2011Pooled it
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- Computer-determined dosage of insulin in the management of neonatal hyperglycaemia (HINT2): protocol of a randomised controlled trial.BMJ open · 2017Trial
- Pilot study of the SPRINT glycemic control protocol in a Hungarian medical intensive care unit.Journal of diabetes science and technology · 2012Trial
- Data entry errors and design for model-based tight glycemic control in critical care.Journal of diabetes science and technology · 2012Trial
- Glucose Management in the ICU: The Bi-Centre GEM-ICU Cohort Study.Acta anaesthesiologica Scandinavica · 2026Article
- Threshold of hyperglycaemia associated with mortality in critically ill patients: a multicentre, prospective, observational study using continuous glucose monitoring.Diabetologia · 2024Observational
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- Estimating Enhanced Endogenous Glucose Production in Intensive Care Unit Patients with Severe Insulin Resistance.Journal of diabetes science and technology · 2022Article
- Impact of time in range during hospitalization on clinical outcomes in diabetic patients with toe amputation: a propensity score matching analysis.BMC surgery · 2022Article
- Estimating Increased EGP During Stress Response in Critically Ill Patients.Journal of diabetes science and technology · 2021Article
- Fifteen-minute Frequency of Glucose Measurements and the Use of Threshold Alarms: Impact on Mitigating Dysglycemia in Critically Ill Patients.Journal of diabetes science and technology · 2021Article
- Insulin sensitivity in critically ill patients: are women more insulin resistant?Annals of intensive care · 2021Article
- Increased insulin resistance in intensive care: longitudinal retrospective analysis of glycaemic control patients in a New Zealand ICU.Therapeutic advances in endocrinology and metabolism · 2021Article
- Risk and reward: extending stochastic glycaemic control intervals to reduce workload.Biomedical engineering online · 2020Article
- Assessment of Glycemic Control Protocol (STAR) Through Compliance Analysis Amongst Malaysian ICU Patients.Medical devices (Auckland, N.Z.) · 2020Article
- 3D kernel-density stochastic model for more personalized glycaemic control: development and in-silico validation.Biomedical engineering online · 2019Article
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIntensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful tight glycemic control (TGC) intervention (SPRINT) on organ failure, morbidity, and thus mortality.
methodsA retrospective analysis of 371 patients (3,356 days) on SPRINT (August 2005 - April 2007) and 413 retrospective patients (3,211 days) from two years prior, matched by Acute Physiology and Chronic Health Evaluation (APACHE) III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA ≤5 each day and its trends over time and cohort/group. Organ-failure free days (all SOFA components ≤2) and number of organ failures (SOFA components >2) are also compared. Cumulative time in 4.0 to 7.0 mmol/L band (cTIB) was evaluated daily to link tightness and consistency of TGC (cTIB ≥0.5) to SOFA ≤5 using conditional and joint probabilities.
resultsAdmission and maximum SOFA scores were similar (P = 0.20; P = 0.76), with similar time to maximum (median: one day; IQR: 13 days; P = 0.99). Median length of stay was similar (4.1 days SPRINT and 3.8 days Pre-SPRINT; P = 0.94). The percentage of patients with SOFA ≤5 is different over the first 14 days (P = 0.016), rising to approximately 75% for Pre-SPRINT and approximately 85% for SPRINT, with clear separation after two days. Organ-failure-free days were different (SPRINT = 41.6%; Pre-SPRINT = 36.5%; P < 0.0001) as were the percent of total possible organ failures (SPRINT = 16.0%; Pre-SPRINT = 19.0%; P < 0.0001). By Day 3 over 90% of SPRINT patients had cTIB ≥0.5 (37% Pre-SPRINT) reaching 100% by Day 7 (50% Pre-SPRINT). Conditional and joint probabilities indicate tighter, more consistent TGC under SPRINT (cTIB ≥0.5) increased the likelihood SOFA ≤5.
conclusionsSPRINT TGC resolved organ failure faster, and for more patients, from similar admission and maximum SOFA scores, than conventional control. These reductions mirror the reduced mortality with SPRINT. The cTIB ≥0.5 metric provides a first benchmark linking TGC quality to organ failure. These results support other physiological and clinical results indicating the role tight, consistent TGC can play in reducing organ failure, morbidity and mortality, and should be validated on data from randomised trials.
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