Abstract
Acute pancreatitis (AP) results in potentially harmful blood glucose fluctuations, affecting patient prognosis. This study aimed to explore the relationship between blood glucose-related indicators and in-hospital mortality in critically ill patients with AP. We extracted data on AP patients from the Multiparameter Intelligent Monitoring in Intensive Care III database. Initial glucose (Glucose_initial), maximum glucose (Glucose_max), minimum glucose (Glucose_min), mean glucose (Glucose_mean), and glucose variability (glucose standard deviation [Glucose_SD] and glucose coefficient of variation [Glucose_CV]) were selected as blood glucose-related indicators. Logistic regression models and the Lowess smoothing curves were used to display the association between significant blood glucose-related indicators and in-hospital mortality. Survivors and non-survivors showed significant differences in Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV (P < 0.05). Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV were risk factors for in-hospital mortality in AP patients (OR > 1; P < 0.05). According to the Lowess smoothing curve, the overall trends of blood glucose-related indicators showed a non-linear correlation with in-hospital mortality. Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV were associated with in-hospital mortality in critically ill patients with AP.
Highlights
Acute pancreatitis (AP) results in potentially harmful blood glucose fluctuations, affecting patient prognosis
Our study found that the Glucose_mean of ICU patients was correlated with mortality, producing a U-shaped curve
Patients with AP had the lowest in-hospital mortality when Glucose_mean was within the range of 85–100 mg/dL. This value is lower than that reported by Siegelaar et al (7–9 mmol/L [126–162 mg/ dL])[19]. This may be because Siegelaar et al included all ICU patients, whereas we only analyzed those with AP
Summary
Acute pancreatitis (AP) results in potentially harmful blood glucose fluctuations, affecting patient prognosis. Logistic regression models and the Lowess smoothing curves were used to display the association between significant blood glucose-related indicators and in-hospital mortality. Glucose_max, Glucose_ mean, Glucose_SD, and Glucose_CV were associated with in-hospital mortality in critically ill patients with AP. Transient stress hyperglycemia in critically ill patients is considered harmless, indicating that the body has normal immune regulation capabilities[5]; fluctuations in blood glucose are considered to cause irreversible organ damage and affect patient p rognosis[6,7].
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