Observational studyMedicine2015
Usefulness of Glycemic Gap to Predict ICU Mortality in Critically Ill Patients With Diabetes.
Observational study in Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Relationship between stress hyperglycaemic ratio (SHR) and critical illness: a systematic review.Cardiovascular diabetology · 2025Pooled it
- Stress hyperglycemia and risk of adverse outcomes in patients with acute ischemic stroke: a systematic review and dose-response meta-analysis of cohort studies.Frontiers in neurology · 2023Pooled it
- Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial.Intensive care medicine · 2021Trial
- Predictive value of stress-induced hyperglycemia for 28-day all-cause mortality in ICU patients with sepsis: a MIMIC-IV-based retrospective cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- Stress hyperglycemia ratio as a predictor of acute kidney injury and its outcomes in critically ill patients.Renal failure · 2025Article
- The Value of Glycemic Gap for Predicting Mortality in ICU in Patients With and Without Diabetes.Journal of diabetes research · 2025Article
- The Interaction and Implication of Stress-Induced Hyperglycemia and Cytokine Release Following Traumatic Injury: A Structured Scoping Review.Diagnostics (Basel, Switzerland) · 2024Article
- Effect of 24 h glucose fluctuations on 30-day and 1-year mortality in patients with acute myocardial infarction: an analysis from the MIMIC-III database.Frontiers in cardiovascular medicine · 2024Article
- Observational
- Diabetes associates with mortality in critically ill patients with SARS-CoV-2 pneumonia: No diabetes paradox in COVID-19.Heliyon · 2023Article
- [Predictive value of stress-induced hyperglycemia on 28 d risk of all-cause death in intensive care patients].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2023Article
- Case-control Investigation of Previously Undiagnosed Diabetes in the Critically Ill.Journal of the Endocrine Society · 2022Article
- Predicting Blood Glucose Concentration after Short-Acting Insulin Injection Using Discontinuous Injection Records.Sensors (Basel, Switzerland) · 2022Article
- Acute and Chronic Glucose Control in Critically Ill Patients With Diabetes: The Impact of Prior Insulin Treatment.Journal of diabetes science and technology · 2022Observational
- The relationship between glycated hemoglobin A1c levels and exacerbation status in the patients with chronic obstructive pulmonary disease.BMC research notes · 2022Article
- Stress Hyperglycemia Ratio as a Prognostic Marker in Diabetic Patients Hospitalized with COVID-19.Infectious disease reports · 2022Article
- Stress hyperglycemia ratio, rather than admission blood glucose, predicts in-hospital mortality and adverse outcomes in moderate-to severe COVID-19 patients, irrespective of pre-existing glycemic status.Diabetes research and clinical practice · 2022Article
- Article
- Glycemic control in critically ill patients with or without diabetes.BMC anesthesiology · 2022Article
- Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study.Diabetes research and clinical practice · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Stress-induced hyperglycemia (SIH) has been independently associated with an increased risk of mortality in critically ill patients without diabetes. However, it is also necessary to consider preexisting hyperglycemia when investigating the relationship between SIH and mortality in patients with diabetes. We therefore assessed whether the gap between admission glucose and A1C-derived average glucose (ADAG) levels could be a predictor of mortality in critically ill patients with diabetes.We retrospectively reviewed the Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores and clinical outcomes of patients with diabetes admitted to our medical intensive care unit (ICU) between 2011 and 2014. The glycosylated hemoglobin (HbA1c) levels were converted to the ADAG by the equation, ADAG = [(28.7 × HbA1c) - 46.7]. We also used receiver operating characteristic (ROC) curves to determine the optimal cut-off value for the glycemic gap when predicting ICU mortality and used the net reclassification improvement (NRI) to measure the improvement in prediction performance gained by adding the glycemic gap to the APACHE-II score.We enrolled 518 patients, of which 87 (17.0%) died during their ICU stay. Nonsurvivors had significantly higher APACHE-II scores and glycemic gaps than survivors (P < 0.001). Critically ill patients with diabetes and a glycemic gap ≥80 mg/dL had significantly higher ICU mortality and adverse outcomes than those with a glycemic gap <80 mg/dL (P < 0.001). Incorporation of the glycemic gap into the APACHE-II score increased the discriminative performance for predicting ICU mortality by increasing the area under the ROC curve from 0.755 to 0.794 (NRI = 13.6%, P = 0.0013).The glycemic gap can be used to assess the severity and prognosis of critically ill patients with diabetes. The addition of the glycemic gap to the APACHE-II score significantly improved its ability to predict ICU mortality.
Indexed as
Identifiers
What OpenQuestion holds
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.