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Table 1 Summary of included studies

From: Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis

Study IDA Study description Patients with TBI, n IIT target Control target Moderate hypoglycaemia definition Severe hypoglycaemia definition Poor neurological outcome definition Infectious complications ICU mortality assessed? Hospital mortality assessed? 30-Day mortality assessed? 90-Day mortality assessed?
   IIT Control           
Arabi 2008 [7] Single centre, medical/surgical ICU patients. IIT vs control (n = 523) 55 39 4.4–6.1 mmol/L 10–11.1 mmol/L NA ≤2.2 mmol/L NA Occurring after 48 h of ICU admission and until 48 h after ICU dischargeb Yes Yes NA NA
Arabi 2011 [24] Single centre, medical/surgical ICU patients. IIT vs control (n = 240). 2x2 factorial design, other comparison permissive underfeeding vs target feeding 34 32 4.4–6.1 mmol/L 10–11.1 mmol/L NA ≤2.2 mmol/L NA Occurring up to 48 h after ICU dischargec Yes Yes NA NA
Bilotta, 2008 [25] Single centre, Patients with TBI admitted to ICU (n = 97), IIT vs control 48 49 4.4–6.7 mmol/L <12 mmol/L <4.44 mmol/L NA (GOS) at 6 months Infections in the ICUd NA NA NA NA
Cinotti 2014 [23] Sub-analysis of multi-centre study, 2 centres, brain injury requiring ICU admission, n = 188, computer-assisted IIT vs control 22 19 4.4–6.0 mmol/L 5.5–9 mmol/L <3.3 mmol/L <2.2 mmol/L GOS 3–5 at 28 and 90 days Pneumonia, 2005 American Thoracic Society (ATS) definition Yes NA Yes Yes
Coester 2010 [26] Blunt TBI with ICU admission, single centre, n = 79 39 40 4.4–6.1 mmol/L <10 mmol/L <4.4 mmol/L <2.2 mmol/L GOS at 6 months Sepsis and or pneumonia in the ICUe Yes Yes NA NA
De la Rosa 2008 [8] Single centre medical/surgical ICU patients, IIT vs control, n = 504 46 44 4.4–6.1 mmol/L 10–11.1 mmol/L 2.2–3.2 mmol/L <2.2 mmol/L NA ICU acquired infectionsf Yes Yes Yes NA
Green 2010 [28] Single centre, mechanically ventilated neurologic patients in the ICU, IIT vs control, n = 81 22 18 4.4–6.1 mmol/L <8.4 mmol/L <3.3 mmol/L <2.2 mmolL mRS 3–5 at 90 days Bloodstream infections and pneumonia in the ICUg NA NA NA Yes
NICE-SUGAR 2015 [13] Sub-analysis of multi-centre trial surgical/medical ICUs, IIT vs control, n = 6104 166 149 4.5–6.0 mmol/L <10 mmol/L 2.3–3.9 mmol/L ≤2.2 mmol/L GOSE 1 − 4 at 24 months Positive blood cultures during admission Yes Yes NA Yes
Van den Berghe 2005 [14] Sub-analysis of single centre surgical ICU patients, IIT vs control, n = 1548 4 7 4.4–6.1 mmol/L <12 mmol/L <3.3 mmol/L <2.2 mmol/L Karnofsky score <60 at 12 months (deaths <60) Positive blood cultures during admission Yes Yes Yes NA
Yang 2009 [27] Single centre, TBI in neurocritical care patients, IIT vs control, n = 233 117 116 4.4–6.1 mmol/L <11.2 mmol/L NA <2.2 mmol/L GOS 1–3 at 6 months ICU infection rateh Yes NA NA NA
  1. TBI traumatic brain injury, IIT intensive insulin therapy, GOS Glasgow Outcome Scale, GOSE extended Glasgow Outcome Scale, mRS modified Rankin Scale
  2. aFirst author, year published
  3. bSepsis, severe sepsis and septic shock were defined according to the 2001 International Sepsis Definitions Conference and types of nosocomial infections were defined according to the National Nosocomial Infections Surveillance System (NNIS)
  4. cIncluding bacteremia, catheter-related bloodstream infection, urinary tract infection, ventilator-associated pneumonia and skin and soft tissue infections identified using the NNIS
  5. dWound infections, pneumonia, urinary infections, bacteremia, defined according to the NNIS
  6. ePneumonia (temperature 38.5 °C, white blood count, positive sputum culture and new infiltrate on chest radiograph); sepsis (documented or suspected infection plus two of four signs of systemic inflammation)
  7. fCDC definition
  8. gBloodstream infections (growth on blood culture not from contaminant) and pneumonia (infiltrate on chest radiograph and growth on sputum culture). Blood cultures and sputum cultures when temperature >101 °F or at the discretion of the treating physician
  9. hPneumonia, sepsis and urinary and wound infections. Infection was defined according to the NNIS