This article is part of the supplement: 32nd International Symposium on Intensive Care and Emergency Medicine

Poster presentation

Does tight glycemic control positively impact on patient mortality?

S Penning1*, AJ Le Compte2, M Signal2, P Massion3, JC Preiser4, GM Shaw5, T Desaive1 and JG Chase2

  • * Corresponding author: S Penning

Author Affiliations

1 Université de Liege, Belgium

2 University of Canterbury, Christchurch, New Zealand

3 CHU de Liège, Belgium

4 Erasme University Hospital, Brussels, Belgium

5 Christchurch Hospital, Christchurch, New Zealand

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Critical Care 2012, 16(Suppl 1):P176 doi:10.1186/cc10783


The electronic version of this article is the complete one and can be found online at: http://ccforum.com/content/16/S1/P176


Published:20 March 2012

© 2012 Penning et al.; licensee BioMed Central Ltd.

Introduction

High and variable blood glucose (BG) levels have been associated with increased mortality. Tight glycemic control (TGC) aims at reducing BG levels to improve patient outcome and mortality. This research evaluates the impact of TGC on mortality.

Methods

This study used glycemic data from 1,488 patients of two cohorts: Glucontrol (n = 704) and SPRINT (n = 784). TGC glycemic outcome is measured by cumulative time in the 4 to 7 mmol/l band (cTIB), defined daily for each patient. Each day, patients were divided into two groups: cTIB <70% and cTIB ≥70%. For each group, odds of living (OL = #lived/#died) was calculated.

Results

OL for cTIB ≥70% patients tends to increase over time while OL for cTIB <70% patients decreases (Figure 1). On Day 1, OL for cTIB <70% patients and cTIB ≥70% patients are similar (OL = 5.1 and OL = 5.5 respectively). The difference between the two groups increases over the ICU stay. On Day 10, OL = 2.8 and OL = 10.5 for cTIB <70% and cTIB ≥70% patients respectively. These results suggest that survival rate is higher when cTIB ≥70% and thus when BG levels are tightly controlled around normoglycemia. The longer patients' ICU stay, the lower survival rate they have when cTIB <70%.

thumbnailFigure 1. Whole-cohort odds of living over ICU stay.

Conclusion

Results show that, irrespective of TGC protocols, high cTIB and thus normoglycemia are associated with higher odds of living. This suggests that TGC positively influences patient outcome.