Association of glycemic variability and prognosis in patients with traumatic brain injury: A retrospective study from the MIMIC-IV database

IF 6.1 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes research and clinical practice Pub Date : 2024-09-26 DOI:10.1016/j.diabres.2024.111869
Linrui Qi , Xin Geng , Rongliang Feng , Shuaishuai Wu , Tengyue Fu , Ning Li , Hongming Ji , Rui Cheng , Hao Wu , Dan Wu , Lian Huang , Qingshan Long , Xiangyu Wang
{"title":"Association of glycemic variability and prognosis in patients with traumatic brain injury: A retrospective study from the MIMIC-IV database","authors":"Linrui Qi ,&nbsp;Xin Geng ,&nbsp;Rongliang Feng ,&nbsp;Shuaishuai Wu ,&nbsp;Tengyue Fu ,&nbsp;Ning Li ,&nbsp;Hongming Ji ,&nbsp;Rui Cheng ,&nbsp;Hao Wu ,&nbsp;Dan Wu ,&nbsp;Lian Huang ,&nbsp;Qingshan Long ,&nbsp;Xiangyu Wang","doi":"10.1016/j.diabres.2024.111869","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Elevated glycemic variability (GV) often occurs in intensive care unit (ICU) patients and is associated with patient prognosis. However, the association between GV and prognosis in ICU patients with traumatic brain injury (TBI) remains unclear.</div></div><div><h3>Method</h3><div>Clinical data of ICU patients with TBI were obtained from the Medical Information Mart for Intensive Care (MIMIC) -IV database. The coefficient of variation (CV) was utilized to quantify GV, while the Glasgow Coma Scale (GCS) was employed to evaluate the consciousness status of TBI patients. Pearson linear correlation analysis, linear regression, COX regression and restricted cubic spline (RCS) were used to investigate the relationship between CV and consciousness impairment, as well as the risk of in-hospital mortality.</div></div><div><h3>Result</h3><div>A total of 1641 ICU patients with TBI were included in the study from the MIMIC-IV database. Pearson linear correlation and restricted cubic spline (RCS) analysis results showed a negative linear relationship between CV and the last GCS (<em>P</em> = 0.002) with no evidence of nonlinearity (P for nonlinear = 0.733). Multivariable linear regression suggested a higher CV was associated with a lower discharge GCS [β (95 %CI) = −1.86 (−3.08 ∼ −0.65), <em>P</em> = 0.003]. Furthermore, multivariable COX regression indicated that CV ≥ 0.3 was a risk factor for in-hospital death in TBI patients [HR (95 %CI) = 1.74 (1.15–2.62), <em>P</em> = 0.003], and this result was also consistent across sensitivity and subgroup analyses.</div></div><div><h3>Conclusion</h3><div>Higher GV is related to poorer consciousness outcomes and increased risk of in-hospital death in ICU patients with TBI. Additional research is needed to understand the logical relationship between GV and TBI progression.</div></div>","PeriodicalId":11249,"journal":{"name":"Diabetes research and clinical practice","volume":"217 ","pages":"Article 111869"},"PeriodicalIF":6.1000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes research and clinical practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0168822724007794","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Elevated glycemic variability (GV) often occurs in intensive care unit (ICU) patients and is associated with patient prognosis. However, the association between GV and prognosis in ICU patients with traumatic brain injury (TBI) remains unclear.

Method

Clinical data of ICU patients with TBI were obtained from the Medical Information Mart for Intensive Care (MIMIC) -IV database. The coefficient of variation (CV) was utilized to quantify GV, while the Glasgow Coma Scale (GCS) was employed to evaluate the consciousness status of TBI patients. Pearson linear correlation analysis, linear regression, COX regression and restricted cubic spline (RCS) were used to investigate the relationship between CV and consciousness impairment, as well as the risk of in-hospital mortality.

Result

A total of 1641 ICU patients with TBI were included in the study from the MIMIC-IV database. Pearson linear correlation and restricted cubic spline (RCS) analysis results showed a negative linear relationship between CV and the last GCS (P = 0.002) with no evidence of nonlinearity (P for nonlinear = 0.733). Multivariable linear regression suggested a higher CV was associated with a lower discharge GCS [β (95 %CI) = −1.86 (−3.08 ∼ −0.65), P = 0.003]. Furthermore, multivariable COX regression indicated that CV ≥ 0.3 was a risk factor for in-hospital death in TBI patients [HR (95 %CI) = 1.74 (1.15–2.62), P = 0.003], and this result was also consistent across sensitivity and subgroup analyses.

Conclusion

Higher GV is related to poorer consciousness outcomes and increased risk of in-hospital death in ICU patients with TBI. Additional research is needed to understand the logical relationship between GV and TBI progression.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
脑外伤患者血糖变化与预后的关系:来自 MIMIC-IV 数据库的回顾性研究。
背景:重症监护病房(ICU)患者的血糖变异性(GV)通常会升高,并且与患者的预后有关。然而,重症监护病房创伤性脑损伤(TBI)患者的血糖变异性与预后之间的关系仍不清楚:方法:重症监护病房创伤性脑损伤患者的临床数据来自重症监护医学信息市场(MIMIC)-IV 数据库。变异系数(CV)用于量化GV,格拉斯哥昏迷量表(GCS)用于评估TBI患者的意识状态。研究采用了皮尔逊线性相关分析、线性回归、COX回归和受限立方样条线(RCS)来研究变异系数与意识障碍之间的关系以及院内死亡风险:研究共纳入了1641名来自MIMIC-IV数据库的ICU创伤性脑损伤患者。皮尔逊线性相关和限制性立方样条曲线(RCS)分析结果显示,CV 与最后一次 GCS 之间存在负线性关系(P = 0.002),且无证据表明存在非线性关系(非线性关系的 P = 0.733)。多变量线性回归表明,较高的 CV 与较低的出院 GCS 相关[β(95 %CI)=-1.86 (-3.08 ∼ -0.65),P = 0.003]。此外,多变量 COX 回归表明,CV ≥ 0.3 是导致 TBI 患者院内死亡的危险因素 [HR (95 %CI) = 1.74 (1.15-2.62),P = 0.003],这一结果在敏感性分析和亚组分析中也是一致的:结论:较高的 GV 与创伤性脑损伤重症监护病房患者较差的意识状况和较高的院内死亡风险有关。要了解 GV 与创伤性脑损伤进展之间的逻辑关系,还需要进行更多的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
期刊最新文献
Evaluation of spatiotemporal associations between COVID-19 pandemic waves and the incidence of pediatric type 1 diabetes in Germany considering time lags: A register-based ecological study. The impact of ethnicity and its definition on diabetes prevalence: A national Australian whole-of-population study. SGLT2 inhibitors, cardiovascular outcomes, and mortality across the spectrum of kidney disease: A systematic review and meta-analysis. Target gene variations of PPAR isoforms may contribute to MODY heterogeneity: A preliminary comparative study with type 2 diabetes Global, regional, and national burden of type 2 diabetes mellitus attributable to particulate matter pollution from 1990 to 2021: An analysis of the global burden of disease study 2021.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1