ArticleCritical care medicine2012
In the critically ill patient, diabetes predicts mortality independent of statin therapy but is not associated with acute lung injury: a cohort study.
Article in Critical care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- The effect of diabetes on the risk and mortality of acute lung injury/acute respiratory distress syndrome: A meta-analysis.Medicine · 2019Pooled it
- Pooled it
- Identification of macrophage activation-related biomarkers in obese type 2 diabetes that may be indicative of enhanced respiratory risk in COVID-19.Scientific reports · 2021Trial
- Current practices of SGLT2 inhibitor use and ketone monitoring in intensive care units: A multicentre observational study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Elevated Hemoglobin A1c and the Risk of Developing ARDS in Two Cohort Studies.CHEST critical care · 2024Article
- Article
- Diabetic lung disease: fact or fiction?Reviews in endocrine & metabolic disorders · 2019Review
- Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database.Critical care (London, England) · 2018Observational
- Pharmacotherapy for Adult Patients with Acute Respiratory Distress Syndrome.Chinese medical journal · 2018Article
- Observational
- Article
- Prognostic factors in the acute respiratory distress syndrome.Clinical and translational medicine · 2015Article
- Obesity-induced adipokine imbalance impairs mouse pulmonary vascular endothelial function and primes the lung for injury.Scientific reports · 2015Article
- Diabetes increases pancreatitis induced systemic inflammation but has little effect on inflammation and cell death in the lung.International journal of experimental pathology · 2014Article
- Statin use and risk of delirium in the critically ill.American journal of respiratory and critical care medicine · 2014Observational
- Outcomes of diabetic and nondiabetic patients undergoing general and vascular surgery.ISRN surgery · 2013Article
- Role of diabetes in the development of acute respiratory distress syndrome.Critical care medicine · 2013Observational
- Inhaled aerosolized insulin ameliorates hyperglycemia-induced inflammatory responses in the lungs in an experimental model of acute lung injury.Critical care (London, England) · 2013Article
- Persistent Hyperglycemia Worsens the Oleic Acid Induced Acute Lung Injury in Rat Model of Type II Diabetes Mellitus.Journal of pharmacy & bioallied sciencesArticle
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9 authors at 1 institution in 2 countries.
Funding
Abstract
objectivesPatients with diabetes mellitus form 23%-30% of published cohorts of critically ill patients. Conflicting published evidence links diabetes mellitus to both higher and lower mortality. Other cohort studies suggest that diabetes mellitus protects against acute lung injury. We hypothesized that diabetes mellitus is an independent risk factor for mortality. We further hypothesized that diabetes mellitus is a risk factor for cardiac overload and not for acute lung injury.
designRetrospective cohort study.
settingThe intensive care unit of a tertiary referral hospital. PATIENTS: From November 1, 2004, to October 1, 2007, a cohort of patients admitted ≥48 hrs to the intensive care unit.
interventionsNone. MEASUREMENTS AND MAIN
resultsOf 2,013 patients, 317 had diabetes mellitus. Ninety-day mortality was higher in the diabetes mellitus patients compared to patients without diabetes mellitus (hazard ratio 1.53, 95% confidence interval 1.29-1.80). This association strengthened after adjusting for confounders and for medication (hazard ratio 1.53, 95% confidence interval 1.07-2.17).We found no association between diabetes mellitus and acute lung injury (relative risk ratio 1.01, 95% confidence interval 0.78-1.32; adjusted relative risk ratio 0.99, 95% confidence interval 0.75-1.31), but diabetes mellitus was a risk factor for cardiac overload (relative risk ratio 1.91, 95% confidence interval 1.30-2.81; adjusted relative risk ratio 1.45, 95% confidence interval 0.97-2.18). Statins were associated with both a reduced risk of mortality (hazard ratio 0.74, 95% confidence interval 0.63-0.87; adjusted hazard ratio 0.53, 95% confidence interval 0.44-0.64) and a decreased risk of developing acute lung injury (relative risk ratio 0.71, 95% confidence interval 0.56-0.89; adjusted relative risk ratio 0.61, 95% confidence interval 0.47-0.79).
conclusionsDiabetes mellitus is an independent risk factor for mortality in critically ill patients and failure to adjust for statins underestimates the size of this association. Diabetes mellitus is not associated with acute lung injury but is associated with cardiac overload. A diagnosis of cardiac overload excludes a diagnosis of acute lung injury. Investigators who do not account for cardiac overload as a competing alternative outcome may therefore falsely conclude that diabetes mellitus protects from acute lung injury.
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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.