Evidence map›Paper›PMID 22938893›Full record

ArticleSurgery2012

Elderly patients may benefit from tight glucose control.

Theresa L Chin, Angela Sauaia, Ernest E Moore, James G Chandler, Jeffrey N Harr, Jeffrey L Johnson, Anirban Banerjee

Abstract read
In one paragraph

Article in Surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Tight glycemic control and cardiovascular effects in type 2 diabetic patients.Heart views : the official journal of the Gulf Heart Association
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Theresa L ChinUniversity of Colorado, Denver, CO, USA.
Angela Sauaia
Ernest E Moore
James G Chandler
Jeffrey N Harr
Jeffrey L Johnson
Anirban Banerjee
University of Colorado Denver · US

Funding

Trauma Reprograms CellsP50GM049222 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI BANERJEE, ANIRBAN · 1993 to 2017
$26.1M
NIGMS NIH HHS P50 GM049222
6 · The paper itself

Abstract

backgroundWhile minimizing hyperglycemia in critically injured patients improves outcomes, it is debatable whether postinjury glucose control should aim for conventional glucose control levels (≤180 mg/dL) or tight glucose control levels (81-108 mg/dL). We queried our 17-year prospective database of patients at risk for postinjury multiple organ failure to examine the association between glucose levels and adverse outcomes.

methodsAcutely injured patients admitted to a Level I trauma center intensive care unit from 1992 to 2008 who were more than 15 years of age, had Injury Severity Scores >15, and who survived >48 hours were eligible for the study. Multiple logistic regression was used to determine the independent association of glucose control with adverse outcomes (death, ventilator-free days, intensive care unit-free days, and major infections), adjusted for Injury Severity Score, age, and red blood cell transfusion in the first 12 hours.

resultsOverall, 2,231 patients were eligible, of whom 153 (6.9%) died. The mean age was 37.8 ± 0.4 years, and the median Injury Severity Score was 27 (interquartile range, 21-35). The majority (77%) of these patients maintained mean glucose within conventional glucose control levels and only 10% achieved mean glucose levels within tight glucose control levels. Nonsurvivors required greater doses of insulin to control glucose levels and had greater mean insulin to glucose ratios (t test; P = .025). After adjusting for confounders, mean glucose remained significantly associated with the studied adverse outcomes. Age significantly modified all these associations with older patients seeming to benefit more from tight glucose control levels than their younger counterparts.

conclusionAge is an effect modifier of the association between glucose levels and adverse outcomes. Future studies including larger samples of elderly trauma patients are needed to determine the ideal levels for glucose control in this growing population.

Indexed as

AdultAge FactorsBlood GlucoseComorbidityCritical CareDiabetes MellitusFemaleHumansHyperglycemiaInfusions, IntravenousInjections, IntravenousInjury Severity ScoreInsulinLogistic ModelsMaleMultiple Organ FailureBlood GlucoseInsulin

Identifiers

PMID22938893
PMCPMC3467010
OpenAlexW2029454915

What OpenQuestion holds

Textmetadata
LicenceTDM
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.