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Association between early blood glucose dynamic trajectory and mortality for critically ill patients with heart failure: Insights from real-world data.
Ning, Yi-Le; Xu, Xiang-Hui; Ma, Qian-Qian; Zhang, Yu; Zhou, Ji-Hong; Sun, Ce.
Afiliación
  • Ning YL; Department of Pulmonary and Critical Care Medicine (PCCM), Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China; The First Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China.
  • Xu XH; The First Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Critical Care Medicine, Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China.
  • Ma QQ; Department of Pulmonary and Critical Care Medicine (PCCM), Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China.
  • Zhang Y; Department of Critical Care Medicine, Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China. Electronic address: zhangyu801026@qq.com.
  • Zhou JH; Department of Pulmonary and Critical Care Medicine (PCCM), Shenzhen Bao'an Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China. Electronic address: zhoujihong71@gzucm.edu.cn.
  • Sun C; The First Clinical School, Guangzhou University of Chinese Medicine, Guangzhou, China. Electronic address: sunce.icu@gmail.com.
Diabetes Res Clin Pract ; 216: 111822, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39154657
ABSTRACT

AIMS:

This study endeavors to explore the ramifications of early dynamic blood glucose (BG) trajectories within the initial 48 h of intensive care unit (ICU) admission on mortality among critically ill heart failure (HF) patients.

METHODS:

The study employed a retrospective observational design, analyzing dynamic BG data of HF patients from the Medical Information Mart for Intensive Care IV database. The BG trajectory subphenotypes were identified using the hierarchical clustering based on the dynamic time-warping algorithm. The primary outcome of the study was 28-day mortality, with secondary outcomes including 180-day and 1-year mortality.

RESULTS:

We screened a total of 21,098 HF patients and finally 15,092 patients were included in the study. Our results identified three distinct BG trajectory subphenotypes increasing (n = 3503), stabilizing (n = 6250), and decreasing (n = 5339). The increasing subphenotype was associated with the highest mortality risk at 28 days, 180 days, and 1 year. The stabilizing and decreasing subphenotypes showed significantly lower mortality risks across all time points, with hazard ratios ranging from 0.85 to 0.88 (P<0.05 for all). Sensitivity analyses confirmed the robustness of these findings after adjusting for various covariates.

CONCLUSIONS:

Increasing BG trajectory within 48 h of admission is significantly associated with higher mortality in patients with HF. It is necessary to devote greater attention to the early BG dynamic changes in HF patients to optimize clinical BG management and enhance patient prognosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glucemia / Enfermedad Crítica / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Diabetes Res Clin Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Glucemia / Enfermedad Crítica / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Diabetes Res Clin Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Irlanda