Trial reportCritical care (London, England)2015
Severe and multiple hypoglycemic episodes are associated with increased risk of death in ICU patients.
Trial report in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers, 2 of them syntheses that pooled 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.
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.
Impact of the Use of a Computerized Protocol for Glucose Control Named CGAOtm on the Outcome of Critically Ill Patients
Glycaemic Alterations in ICU: an Observational, Prospective Cohort Study
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Emergency risk stratification using the TyG index: a multi-center cohort study on nonlinear association with 28-day mortality among critically ill patients transferred from the ED to the ICU.Frontiers in medicine · 2025Article
- Impact of glycemic treatment and blood glucose monitoring on outcomes in patients with acute ischemic stroke without prior diabetes: a longitudinal cohort study.Diabetology & metabolic syndrome · 2024Article
- Hyperglycemia and glucose variability are associated with worse survival in mechanically ventilated COVID-19 patients: the prospective Maastricht Intensive Care Covid Cohort.Diabetology & metabolic syndrome · 2023Article
- Estimating Enhanced Endogenous Glucose Production in Intensive Care Unit Patients with Severe Insulin Resistance.Journal of diabetes science and technology · 2022Article
- Hyperglycemia and Hypoglycemia Are Associated with In-Hospital Mortality among Patients with Coronavirus Disease 2019 Supported with Extracorporeal Membrane Oxygenation.Journal of clinical medicine · 2022Article
- Pros and cons of continuous glucose monitoring in the intensive care unit.World journal of clinical cases · 2021Review
- Hypoglycemic episodes predict length of stay in patients with acute burns.Journal of critical care · 2021Article
- Risk-Based Care: Let's Think Outside the Box.Frontiers in medicine · 2021Article
- Elevation of blood glucose level predicts worse outcomes in hospitalized patients with COVID-19: a retrospective cohort study.BMJ open diabetes research & care · 2020Article
- Glycemic Variability: An Independent Predictor of Mortality and the Impact of Age in Pediatric Intensive Care Unit.Frontiers in pediatrics · 2020Article
- European Stroke Organisation (ESO) guidelines on glycaemia management in acute stroke.European stroke journal · 2018Article
- Continuous Glucose Monitoring Measures Can Be Used for Glycemic Control in the ICU: An In-Silico Study.Journal of diabetes science and technology · 2018Article
- Management of critically ill patients with diabetes.World journal of diabetes · 2017Review
- Hypoglycemia and glycemic variability are associated with mortality in non-intensive care unit hospitalized infectious disease patients with diabetes mellitus.Journal of diabetes investigation · 2016Article
- Evaluation and treatment of hyperglycemia in critically ill patients.Acta bio-medica : Atenei Parmensis · 2016Review
- Hyperglycemia in Critically Ill Patients: Current Approaches and Management Strategies.In vivo (Athens, Greece)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 11 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn a randomized controlled trial comparing tight glucose control with a computerized decision support system and conventional protocols (post hoc analysis), we tested the hypothesis that hypoglycemia is associated with a poor outcome, even when controlling for initial severity.
methodsWe looked for moderate (2.2 to 3.3 mmol/L) and severe (<2.2 mmol/L) hypoglycemia, multiple hypoglycemic events (n ≥3) and the other main components of glycemic control (mean blood glucose level and blood glucose coefficient of variation (CV)). The primary endpoint was 90-day mortality. We used both a multivariable analysis taking into account only variables observed at admission and a multivariable matching process (greedy matching algorithm; caliper width of 10(-5) digit with no replacement).
resultsA total of 2,601 patients were analyzed and divided into three groups: no hypoglycemia (n =1,474), moderate hypoglycemia (n =874, 34%) and severe hypoglycemia (n =253, 10%). Patients with moderate or severe hypoglycemia had a poorer prognosis, as shown by a higher mortality rate (36% and 54%, respectively, vs. 28%) and decreased number of treatment-free days. In the multivariable analysis, severe (odds ratio (OR), 1.50; 95% CI, 1.36 to 1.56; P =0.043) and multiple hypoglycemic events (OR, 1.76, 95% CI, 1.31 to 3.37; P <0.001) were significantly associated with mortality, whereas blood glucose CV was not. Using multivariable matching, patients with severe (53% vs. 35%; P <0.001), moderate (33% vs. 27%; P =0.029) and multiple hypoglycemic events (46% vs. 32%, P <0.001) had a higher 90-day mortality.
conclusionIn a large cohort of ICU patients, severe hypoglycemia and multiple hypoglycemic events were associated with increased 90-day mortality.
trial registrationClinicaltrials.gov Identifier: NCT01002482 . Registered 26 October 2009.
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Registered trials
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.