Trial reportDiabetic medicine : a journal of the British Diabetic Association2026
Glycaemic penalty index as an independent predictor of healthcare-associated infection in surgical inpatients: A nested cohort study from the STOIC-D surgery trial.
Trial report in Diabetic medicine : a journal of the British Diabetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo evaluate the utility of the Glycemic Penalty Index (GPI), a validated tool for assessing risk of adversity associated with inpatient dysglycaemia in surgical intensive care patients, in predicting adverse clinical outcomes among surgical inpatients at a quaternary Australian hospital.
methodsThis nested cohort study analysed data from the control arm of the Specialist Treatment of Inpatients: Caring for Diabetes in Surgery (STOIC-D Surgery) randomised controlled trial. The GPI was calculated using blood glucose values to derive patient-day weighted mean GPI (PDWMGPI). Univariable and multivariable analyses assessed associations between GPI and the outcomes of healthcare-associated infection (HAI) and acute kidney injury.
results691 surgical inpatients with diabetes receiving standard care were included. On multivariable analysis, increasing PDWMGPI was independently associated with healthcare-associated infection (odds ratio 1.02 per one-unit increase, 95% CI 1.01-1.04, p = 0.008).
conclusionThe association between PDWMGPI and HAI suggests that linearised summary glycaemic measures may support clinicians in identifying patients at increased risk of adverse inpatient outcomes related to glycaemic patterns when interpreted alongside clinical factors. The simplicity of GPI as a single score may assist risk stratification and prioritisation of specialist diabetes input in surgical inpatient settings.
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