NDLI: Glycemic variability and in-hospital death of critically ill patients and the role of ventricular arrhythmias

Content Provider	Springer Nature : BioMed Central
Author	Su, Yuhao Fan, Weiguo Liu, Yang Hong, Kui
Abstract	Background Abnormal glycemic variability is common in the intensive care unit (ICU) and is associated with increased in-hospital mortality and major adverse cardiovascular events, but little is known about whether adverse outcomes are partly mediated by ventricular arrhythmias (VA). We aimed to explore the association between glycemic variability and VA in the ICU and whether VA related to glycemic variability mediate the increased risk of in-hospital death. Methods We extracted all measurements of blood glucose during the ICU stay from The Medical Information Mart for Intensive Care IV (MIMIC-IV) database version 2.0. Glycemic variability was expressed by the coefficient of variation (CV), which was calculated by the ratio of standard deviation (SD) and average blood glucose values. The outcomes included the incidence of VA and in-hospital death. The KHB (Karlson, KB & Holm, A) is a method to analyze the mediation effect for nonlinear models, which was used to decompose the total effect of glycemic variability on in-hospital death into a direct and VA-mediated indirect effect. Results Finally, 17,756 ICU patients with a median age of 64 years were enrolled; 47.2% of them were male, 64.0% were white, and 17.8% were admitted to the cardiac ICU. The total incidence of VA and in-hospital death were 10.6% and 12.8%, respectively. In the adjusted logistic model, each unit increase in log-transformed CV was associated with a 21% increased risk of VA (OR 1.21, 95% CI: 1.11–1.31) and a 30% increased risk (OR 1.30, 95% CI: 1.20–1.41) of in-hospital death. A total of 3.85% of the effect of glycemic variability on in-hospital death was related to the increased risk of VA. Conclusion High glycemic variability was an independent risk factor for in-hospital death in ICU patients, and the effect was caused in part by an increased risk of VA.
Related Links	https://cardiab.biomedcentral.com/counter/pdf/10.1186/s12933-023-01861-0.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14752840
DOI	10.1186/s12933-023-01861-0
Journal	Cardiovascular Diabetology
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2023-06-12
Access Restriction	Open
Subject Keyword	Diabetes Angiology Cardiology Blood glucose Glycemic variability Ventricular arrhythmias In-hospital death
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Internal Medicine Endocrinology, Diabetes and Metabolism
Journal Impact Factor	8.5/2023
5-Year Journal Impact Factor	8.9/2023

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