Does intensive insulin therapy really reduce mortality in critically ill surgical patients? A reanalysis of meta-analytic data

Table 2 Summary of pooled results of primary and sensitivity analyses

	Pooled results
Analysis	All trials^a	Surgical patient subgroup	Medical patient subgroup	P value^b
Primary
Trials included in more recent review [2]^c	0.93 (0.84 to 1.04, P = 0.20), I² = 45% (2 to 69%); 26 trials; 13,549 patients	0.85 (0.69 to 1.04, P = 0.11), I² = 51% (1 to 75%); 18 trials; 6,164 patients	1.02 (0.95 to 1.09, P = 0.61), I² = 0% (0 to 41%); 18 trials; 7,113 patients	0.10
Sensitivity
Only mixed ICU trials enrolling both surgical and medical patients	0.97 (0.85 to 1.11, P = 0.66), I² = 54% (0 to 79%); 14 trials; 10,121 patients	0.98 (0.80 to 1.19, P = 0.82), I² = 40% (0 to 75%); 12 trials; 4,137 patients	1.03 (0.94 to 1.13, P = 0.51), I² = 8% (0 to 62%); 12 trials; 5,722 patients	0.66
Incorporating additional trials included in earlier review [1]	0.96 (0.87 to 1.06, P = 0.43), I² = 36% (0 to 61%); 32 trials; 15,051 patients	0.89 (0.74 to 1.08, P = 0.24), I² = 45% (0 to 71%); 21 trials; 6,644 patients	1.02 (0.96 to 1.09, P = 0.46), I² = 0% (0 to 31%); 21 trials; 8,135 patients	0.18
Only trials achieving mean blood glucose 4.4 to 6.1 mM in IIT group	0.80 (0.60 to 1.07, P = 0.14), I² = 43% (0 to 76%); 12 trials; 2,879 patients	0.76 (0.57 to 1.01, P = 0.06), I² = 10% (0 to 68%); 9 trials; 2,474 patients	1.04 (0.71 to 1.53, P = 0.82), I² = 7% (0 to 76%); 6 trials; 289 patients	0.20

Data presented as risk ratio (95% confidence interval). I², percentage of total variation across studies due to between-study heterogeneity rather than chance; ICU, intensive care unit; IIT, intensive insulin therapy. ^aIncludes also mixed ICU trials for which separate surgical and medical subgroup data were not available [19, 20]. ^bSurgical versus medical interaction. ^cSee also Figure 1.

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