The glycemic gap and stress glycemia ratio may predict ICU mortality in critically ill patients with AKI

This study is published in BMC Nephrology.

It is already known that Acute hyperglycemia is a risk factor for acute kidney injury occurrence and mortality in various diseases. In the present study, a team of researchers investigated the relationship between stress-induced hyperglycemia and adverse outcomes in critically ill patients with a history of AKI by extracting clinical data from Multiparameter Intelligent Monitoring in Intensive Care III version 1.4.

To calculate the glycemic gap and stress hyperglycemia ratio (SHR), researchers used Blood glucose and glycosylated haemoglobin during the first 24 h of ICU admission.

The outcomes measured in the study were ICU mortality and the need for renal replacement therapy.

The critical points of the study are:

• Higher values were recorded for glycemic gap, and SHR in those with increased need for RRT, higher mortality rates and longer ICU stay.

• There was an independent association between a higher glycemic gap and SHR with ICU mortality. The OR was 1.01 and 1.32, respectively.

• The association of glycemic gap and SHR were only significant in the non-diabetic population as for the outcome of ICU mortality having OR 2.25 and 1.99, respectively.

Concluding further, they said, Based on the results of our study, glycemic gap and SHR might be potential prognostic indicators of ICU mortality in critically ill patients with AKI, especially in the non-diabetic population.

We found that both glycemic gap and SHR, instead of admission glycemia alone, were related to poor ICU outcomes, even after adjustment for important confounders, they noted.

Further reading:

https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-023-03278-z