Observational studyCritical care (London, England)2015
Influence of a strict glucose protocol on serum potassium and glucose concentrations and their association with mortality in intensive care patients.
Observational study in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 17 citations in OpenAlex.
- Serum glucose-to-potassium ratio is associated with delirium and all-cause mortality in intensive care unit patients: insights from the MIMIC database analysis.American journal of translational research · 2026Article
- The ratio of serum glucose to potassium is associated with poor prognosis in patients with severe acute myocardial infarction.Scientific reports · 2025Article
- The U shape relationship between glucose and potassium ratio and mortality in patients with subarachnoid hemorrhage in the US population.Scientific reports · 2025Article
- Interpretable machine learning model for outcome prediction in patients with aneurysmatic subarachnoid hemorrhage.Critical care (London, England) · 2025Article
- Association between serum glucose potassium ratio and mortality in critically ill patients with intracerebral hemorrhage.Scientific reports · 2024Article
- Serum glucose/potassium ratio as an indicator of early and delayed outcomes of acute carbon monoxide poisoning.Toxicology research · 2024Article
- Glycemic Variability As a Prognostic Factor for Mortality in Patients With Critical Illness: A Systematic Review and Meta-Analysis.Critical care explorations · 2024Review
- Serum glucose-potassium ratio predicts inhospital mortality in patients admitted to coronary care unit.Revista da Associacao Medica Brasileira (1992) · 2024Observational
- Serum osmolality was non-linearly associated with the risk of all-cause and cardiovascular mortality in patients with diabetes.BMJ open diabetes research & care · 2023Article
- The blood glucose-potassium ratio at admission predicts in-hospital mortality in patients with acute type A aortic dissection.Scientific reports · 2023Article
- Current Practices in Missing Data Handling for Interrupted Time Series Studies Performed on Individual-Level Data: A Scoping Review in Health Research.Clinical epidemiology · 2021Article
- Issues for the management of people with diabetes and COVID-19 in ICU.Cardiovascular diabetology · 2020Review
- Clinical Management of Diabetes Mellitus in the Era of COVID-19: Practical Issues, Peculiarities and Concerns.Journal of clinical medicine · 2020Review
- Handling Missing Values in Interrupted Time Series Analysis of Longitudinal Individual-Level Data.Clinical epidemiology · 2020Article
- Association between potassium concentrations, variability and supplementation, and in-hospital mortality in ICU patients: a retrospective analysis.Annals of intensive care · 2019Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTight glucose control therapy (TGC) has been implemented to control hyperglycemia in ICU patients. TGC may also influence serum potassium concentrations. We therefore investigated the influence of TGC on both serum glucose and serum potassium concentrations and associated mortality.
methodWe performed a retrospective analysis including all patients admitted to the ICU of a tertiary hospital for 24 hours or more and with at least three serum glucose and serum potassium concentrations between 1999-2001 (conventional period), 2002-2006 (implementation period) or 2007-2009 (TGC period). Segmented regression analysis was used to estimate changes in outcomes that occurred after the intervention controlling for pre-intervention trends. Means and standard deviations (SDs) of serum glucose and serum potassium concentrations, and rate of severe hypoglycemia (≤ 2.2 mmol/L) and hypokalemia (≤ 3 mmol/L), were compared between the TGC and conventional period.
resultsAlthough mean serum glucose concentrations dropped 2.1 mmol/L (95% CI =-1.8 to -2.3 mmol/L, p<0.002), mean serum potassium concentrations did not change (absolute increase 0.02 mmol/L; 95% CI = -0.06 to 0.09 mmol/L, p=0.64). The rate of severe hypoglycemia increased with 5.9% (95% CI=-3.0 to -8.9, p<0.002), but the rate of hypokalemia remained equal (absolute reduction 4.8%; 95% CI = -11.1% to 1.5%, p=0.13). The SD of serum glucose concentrations within a patient did not change, while the SD of serum potassium concentrations even decreased 0.04 mmol/L (95% CI = -0.01 to -0.07, p = 0.01). ICU mortality decreased but this decrease was not significant (absolute difference -3.63%; 95% CI = -9.33 to 2.09, p = 0.20). Mean serum glucose concentrations, mean serum potassium concentrations and SDs of both serum glucose and serum potassium concentrations were all independently associated with ICU mortality. Highest mortality rates were seen at both the lowest and highest mean values (U/J-shaped association) and mortality rates increased with increasing variability (SDs) for both serum glucose and serum potassium concentrations.
conclusionOur study shows that a TGC was not associated with an increased risk of serum potassium related events. Low and high mean values and high variability of both serum glucose and serum potassium concentrations are predictors for high ICU mortality.
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