ArticleAnnals of intensive care2011
Mild hypoglycemia is strongly associated with increased intensive care unit length of stay.
Article in Annals of intensive care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline.Journal of diabetes science and technology · 2020Guideline
- Is intensive glucose control bad for critically ill patients? A systematic review and meta-analysis.International journal of biological sciences · 2020Pooled it
- Effects of glucose-dependent insulinotropic polypeptide on gastric emptying, glycaemia and insulinaemia during critical illness: a prospective, double blind, randomised, crossover study.Critical care (London, England) · 2015Trial
- Intravenous insulin therapy during lung resection does not affect lung function or surfactant proteins.BMC pulmonary medicine · 2014Trial
- Article
- Article
- Association between stress hyperglycemia ratio and all-cause mortality in critically ill patients with sepsis: results from the MIMIC-IV database.European journal of medical research · 2025Observational
- Assessing glycemic variability in critically ill patients: A prospective cohort study comparing insulin infusion therapy with insulin sliding scale.Scientific reports · 2024Observational
- Preoperative carbohydrate load to reduce perioperative glycemic variability and improve surgical outcomes: A scoping review.World journal of diabetes · 2023Article
- Predicting hypoglycemia in critically Ill patients using machine learning and electronic health records.Journal of clinical monitoring and computing · 2022Article
- Expert consensus on the glycemic management of critically ill patients.Journal of intensive medicine · 2022Article
- Hypoglycemic episodes predict length of stay in patients with acute burns.Journal of critical 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
- Electronic Measurement of a Clinical Quality Measure for Inpatient Hypoglycemic Events: A Multicenter Validation Study.Medical care · 2020Article
- Initial management of diabetic ketoacidosis and prognosis according to diabetes type: a French multicentre observational retrospective study.Annals of intensive care · 2019Article
- The Impact of Serum Glucose on the Predictive Value of Serum Lactate for Hospital Mortality in Critically Ill Surgical Patients.Disease markers · 2019Article
- Evaluation of Insulin Use and Hypoglycemia in Hospitalized Elderly Patients.Hospital pharmacy · 2017Article
- In Silico Testing of an Artificial-Intelligence-Based Artificial Pancreas Designed for Use in the Intensive Care Unit Setting.Journal of diabetes science and technology · 2016Article
- Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study.Critical care (London, England) · 2015Observational
- Point-of-care blood glucose testing for diabetes care in hospitalized patients: an evidence-based review.Journal of diabetes science and technology · 2014Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypoglycemia is associated with increased mortality in critically ill patients. The impact of hypoglycemia on resource utilization has not been investigated. The objective of this investigation was to evaluate the association of hypoglycemia, defined as a blood glucose concentration (BG) < 70 mg/dL, and intensive care unit (ICU) length of stay (LOS) in three different cohorts of critically ill patients.
methodsThis is a retrospective investigation of prospectively collected data, including patients from two large observational cohorts: 3,263 patients admitted to Stamford Hospital (ST) and 2,063 patients admitted to three institutions in The Netherlands (NL) as well as 914 patients from the GLUCONTROL trial (GL), a multicenter prospective randomized controlled trial of intensive insulin therapy.
resultsPatients with hypoglycemia were more likely to be diabetic, had higher APACHE II scores, and higher mortality than did patients without hypoglycemia. Patients with hypoglycemia had longer ICU LOS (median [interquartile range]) in ST (3.0 [1.4-7.1] vs. 1.2 [0.8-2.3] days, P < 0.0001), NL (5.2 [2.6-10.3] vs. 2.0 [1.3-3.2] days, P < 0.0001), and GL (9 [5-17] vs. 5 [3-9] days, P < 0.0001). For the entire cohort of 6,240 patients ICU LOS was 1.8 (1.0-3.3) days for those without hypoglycemia and 3.0 (1.5-6.7) days for those with a single episode of hypoglycemia (P < 0.0001). This was a consistent finding even when patients were stratified by severity of illness or survivor status. There was a strong positive correlation between the number of episodes of hypoglycemia and ICU LOS among all three cohorts.
conclusionsThis multicenter international investigation demonstrated that hypoglycemia was consistently associated with significantly higher ICU LOS in heterogeneous cohorts of critically ill patients, independently of severity of illness and survivor status. More effective methods to prevent hypoglycemia in these patients may positively impact their cost of care.
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Registered trials
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