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The prognostic role of peak glycemia and glucose variability in trauma: a single-center investigation

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Abstract

Aim

Admission hyperglycemia and glucose variability were associated with mortality in critically ill patients, but data on trauma patients are to date scarce and heterogeneous.

Methods

We assessed the prognostic role of ICU death of admission and peak glycemia and glucose variability (indicated by the standard deviation of mean glucose levels and the coefficient of variation of glucose) in 252 patients consecutively admitted for trauma in our ICU (January 1, 2016–December 31, 2018).

Results

The in-ICU mortality rate was 17% (43/252). When compared to patients who died during ICU stay, survivors were younger (p = 0.001), more frequently males (p = 0.002), with a lower incidence of hypertension (p = 0.023). Higher values of SAPS II, SOFA and ISS were observed in nonsurvivors (p < 0.001, p < 0.001, p < 0.001, respectively). Survivors exhibited significantly lower values of admission glycemia (p = 0.001), peak glycemia (p = 0.002) and mean glucose values measured during the first 24 h since ICU admission (p = 0.001). Glucose variability was significantly higher in nonsurvivors, as indicated by higher values of SD and CV (p = 0.001 and p = 0.001, respectively). At multivariate regression analysis, admission glycemia (Model 1), peak glycemia (Model 2) and glucose variability (Model 3 and 4) were independent predictors for in-ICU mortality.

Conclusions

Our findings indicate that not only admission glycemia but also peak glycemia and glucose variability show a correlation with in-ICU mortality in trauma patients.

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Authors and Affiliations

  1. Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 1, 50134, Florence, Italy

    Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Marco Ciapetti, Filippo Socci & Adriano Peris

Authors
  1. Chiara Lazzeri
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  2. Manuela Bonizzoli
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  3. Giovanni Cianchi
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  4. Marco Ciapetti
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  5. Filippo Socci
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  6. Adriano Peris
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Correspondence to Chiara Lazzeri.

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The authors declare that they have no conflict of interest.

Ethical statement

The study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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The Internal Review Board approved the study

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Informed consent for study participation and data publication was obtained from patients or their family members

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Lazzeri, C., Bonizzoli, M., Cianchi, G. et al. The prognostic role of peak glycemia and glucose variability in trauma: a single-center investigation. Acta Diabetol 57, 931–935 (2020). https://doi.org/10.1007/s00592-020-01493-w

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  • DOI: https://doi.org/10.1007/s00592-020-01493-w

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