Relationship between glycemic Lability Index, infections and outcome in critically ill patients

Introduction

Hyperglycemia and glucose variability are important factors associated with morbidity and mortality in critically ill patients [1, 2]. Our objective was to determine the association between the glucose Lability Index (LI), infections and outcome in critical illness.

Methods

We performed a retrospective study in 2,943 adult patients admitted to our ICU from 2004 until 2010. Glucose variability was calculated for all subjects as the LI [3] during the hospital stay on capillary, arterial and venous blood. The ROC curve was performed to verify discrimination of the LI towards mortality and ICU infections.

Results

There were 709 infections and 447 deaths. There was a significant interaction between the LI and infections in patients. The LI had a great ability to predict hospital mortality (area under the curve = 0.62, 95% CI = 0.59 to 0.65, P < 0.5; Figure 1) but moreover infections (area under the curve = 0.80, 95% CI = 0.78 to 0.82, P < 0.5; Figure 2).

Figure 1

(abstract P7)

Figure 2

(abstract P7)

Conclusion

Glucose variability has ability to predict outcome but moreover infections in patients in the ICU, because it is a predictor of clinical outcomes in patients with hyperglycemia and diabetes. Strategies to reduce glucose variability should be studied to improve the outcomes in ICU patients.