Diabetes Is Not Associated With Increased 90-Day Mortality Risk in Critically Ill Patients With Sepsis.

Abstract

OBJECTIVES:

To determine the association of pre-existing diabetes, hyperglycemia, and hypoglycemia during the first 24 hours of ICU admissions with 90-day mortality in patients with sepsis admitted to the ICU.

DESIGN:

We used mixed effects logistic regression to analyze the association of diabetes, hyperglycemia, and hypoglycemia with 90-day mortality (n = 128,222).

SETTING:

All ICUs in the Netherlands between January 2009 and 2014 that participated in the Dutch National Intensive Care Evaluation registry.

PATIENTS:

All unplanned ICU admissions in patients with sepsis.

INTERVENTIONS:

The association between 90-day mortality and pre-existing diabetes, hyperglycemia, and hypoglycemia, corrected for other factors, was analyzed using a generalized linear mixed effect model.

MEASUREMENTS AND MAIN RESULTS:

In a multivariable analysis, diabetes was not associated with increased 90-day mortality. In diabetes patients, only severe hypoglycemia in the absence of hyperglycemia was associated with increased 90-day mortality (odds ratio, 2.95; 95% CI, 1.19-7.32), whereas in patients without pre-existing diabetes, several combinations of abnormal glucose levels were associated with increased 90-day mortality.

CONCLUSIONS:

In the current retrospective large database review, diabetes was not associated with adjusted 90-day mortality risk in critically ill patients admitted with sepsis.

• Authors: Lonneke A van Vught, Rebecca Holman, Evert de Jonge, Nicolette F de Keizer, Tom van der Poll
• Journal: Critical care medicine (Crit Care Med) Vol. 45 Issue 10 Pg. e1026-e1035 (Oct 2017) ISSN: 1530-0293 [Electronic] United States
• PMID: 28737575 (Publication Type: Journal Article)

Topics

• Aged
• Critical Illness (mortality)
• Diabetes Mellitus (mortality)
• Female
• Humans
• Hyperglycemia (mortality)
• Hypoglycemia (mortality)
• Intensive Care Units
• Logistic Models
• Male
• Middle Aged
• Netherlands (epidemiology)
• Registries
• Retrospective Studies
• Sepsis (mortality)