Blood glucose-related indicators are associated with in-hospital mortality in critically ill patients with acute pancreatitis

Abstract

Acute pancreatitis (AP) results in potentially harmful blood glucose fluctuations, affecting patient prognosis. This study aimed to explore the relationship between blood glucose-related indicators and in-hospital mortality in critically ill patients with AP. We extracted data on AP patients from the Multiparameter Intelligent Monitoring in Intensive Care III database. Initial glucose (Glucose_initial), maximum glucose (Glucose_max), minimum glucose (Glucose_min), mean glucose (Glucose_mean), and glucose variability (glucose standard deviation [Glucose_SD] and glucose coefficient of variation [Glucose_CV]) were selected as blood glucose-related indicators. Logistic regression models and the Lowess smoothing curves were used to display the association between significant blood glucose-related indicators and in-hospital mortality. Survivors and non-survivors showed significant differences in Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV (P < 0.05). Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV were risk factors for in-hospital mortality in AP patients (OR > 1; P < 0.05). According to the Lowess smoothing curve, the overall trends of blood glucose-related indicators showed a non-linear correlation with in-hospital mortality. Glucose_max, Glucose_mean, Glucose_SD, and Glucose_CV were associated with in-hospital mortality in critically ill patients with AP.

Usefulness of Random Forest Algorithm in Predicting Severe Acute Pancreatitis

“…However, transient stress hyperglycemia in critically ill patients is considered harmless in some studies, indicating that the body has normal immune regulation ability (Lu et al, 2021), the subsequent derangement of glucose homeostasis could cause damage to the body (Pendharkar et al, 2016). Blood glucoserelated indicators are associated with in-hospital mortality in critically ill patients with AP (Lu et al, 2021). Our LR model also shows that glucose is a useful predictor of SAP (Figure 1).…”

“…Clinical evidence shows hyperglycemia is the common early feature of AP and abnormal glucose metabolism is present in almost 40% of AP patients (Banks et al, 2013;Chen et al, 2021). According to the traditional view, the mechanism is that the damage of organisms caused by AP activate the neuroendocrine system and lead to the secretion of many stress hormones (Binker and Cosen-Binker, 2014;Sun et al, 2019;Lu et al, 2021). Meanwhile, it is also related to the damage of the endocrine pancreas caused by SAP attacks.…”

“…Sun et al has suggested that the level of glucose in serum is positively correlated with the APACHE II scores, TNF-a, and CRP in AP (Sun et al, 2019). However, transient stress hyperglycemia in critically ill patients is considered harmless in some studies, indicating that the body has normal immune regulation ability (Lu et al, 2021), the subsequent derangement of glucose homeostasis could cause damage to the body (Pendharkar et al, 2016). Blood glucoserelated indicators are associated with in-hospital mortality in critically ill patients with AP (Lu et al, 2021).…”

Glycemic Variability As a Prognostic Factor for Mortality in Patients With Critical Illness: A Systematic Review and Meta-Analysis

“…Increased CV of BG values as a measure of GV is probably associated with increased mortality (moderate certainty) (Supplemental Table 7, http://links.lww.com/CCX/B288). Pooled mean difference of CV was 0.05 (95% CI, 0.04–0.07) higher in those who died (20–22, 28–36, 44, 45). Pooled aOR of mortality per 10% increase CV was 1.34 (95% CI, 1.15–1.57) (20–22, 28–36, 44, 45).…”

Relationship between blood glucose levels and length of hospital stay in patients with acute pancreatitis: An analysis of MIMIC‐III database

“…19 Another study found that hyperglycemic state serves as an important indicator of multi-organ failure and poor prognosis in patients with SAP, by comparing blood glucose levels with organ failure rate, ICU transfer rate, and mortality rate. 20,21 In addition, Yan et al 22 found that Glucose_max, Glucose_mean, Glucose_ SD, and Glucose_CV were associated with mortality of patients hospitalized with AP. Interestingly, Yildirim et al 23 demonstrated that anti-inflammatory and antioxidant therapy can alleviate the condition of patients with AP and hinder further progression.…”