Effect of initial dynamic blood glucose time window on prognosis of critically ill patients

Abstract

Objective To explore the impact of initial dynamic blood glucose on the prognosis of critically ill patients in intensive care unit (ICU) in the first 24 hours. Methods Totally 104 critically ill patients were selected from March 2012 to March 2013. The dynamic blood glucose was monitored and acute physiology and chronic health evaluation (APACHE Ⅱ) scores were collected in the first 24 hours in ICU. Four subgroups were further divided by the results of hypoglycemia time windows, hyperglycemia time windows, euglycemia time windows and APACHE Ⅱ scores[G1 (P0-P25), G2 (P25-P50), G3 (P50-P75), G4 (P75-P100)]. Variance and Chi-square test were used to analyze and compare the changes of APACHE Ⅱ scores and rate of mortality. Results The APACHE Ⅱ scores in death group (32.5±7.6) was significantly higher than that in survival group (19.9±6.5), the hypoglycemia time windows (2.29 (0-7.68) h) and hyperglycemia time windows (14.3 (3.36-24.00) h) in death group were significantly longer than those in the survival group (0.41 (0-2.88), 3.8 (0-12.96) h), and the euglycemia time windows (7.41 (0.24-17.52) h) in death group was significantly shorter than that in the survival group (19.79 (11.28-24.00) h,t=5.65, Z=-2.01,-3.01,-3.95, all P 0.05). Conclusion The euglycemia time windows is positively correlated with the prognosis of patients in ICU, and hyperglycemia time windows is negatively correlated with the prognosis of the patients. The initial dynamic blood glucose time window plays an important role in predicting the progress and prognosis of severe disease. Key words: Dynamic blood glucose monitoring; Acute physiology and chronic health evaluation; Intensive care; Prognosis