Admission blood sugar may predict prognosis in sepsis patients: Study

China: Sepsis, being one of the severe illnesses, is usually encountered in critically sick patients, particularly when diabetes is present.

According to the findings of a new study, admission blood sugar, particularly in terms of 70 mg/dl, is the main signal in predicting the lower 30-day survival probability of septic patients without diabetes. The findings of this study were published in the journal Frontiers in Medicine.

This study was conducted by Xiaoyuan Wei and the team with the objective to check if admission blood glucose levels are related to the prognosis and fate of septic patients. In the following study, the demographic data of septic patients in the Medical Information Mart for Intensive Care III (MIMIC III, version 1.4) were examined and analyzed retrospectively between June 2001 and October 2012.

The Chi-square and Fisher's exact tests were used to compare qualitative factors in septic patients with varying glucose levels, as well as 30-day mortality in septic patients with or without diabetes. The risk variables for 30-day mortality were determined using univariate and stepwise multivariate Cox regression analysis. The 30-day survival probability in each subgroup was determined using Kaplan-Meier analysis.

In the end, 2,948 septic patients were included in the research. The total 30-day death rate was 32.4%, with no difference between diabetes and non-diabetic septic patients. Admission blood glucose levels of 70 mg/dl were shown to be substantially linked with 30-day mortality in septic patients who did not have diabetes. After controlling for confounders, age >65 years, the Sequential Organ Failure Assessment (SOFA) score >5, lactic acid >2 mmol/L, and platelet abnormalities were revealed to be independent risk factors for 30-day death in diabetic septic patients. Age >65 years, non-White or non-Black patients, SOFA score >5, blood glucose 70 mg/dl, anion gap (AG) >2 mmol/L, Lac, urea nitrogen >21 mg/d, alanine aminotransferase, total bilirubin >1.2 mg/d, and poor hemoglobin were independent risk factors for 30-day death in the non-diabetes group.

In conclusion, it was believed that admission blood glucose levels might be a crucial signal for doctors in determining a more appropriate and precise treatment method for septic patients. Furthermore, researchers revealed somewhat distinct customized prognostic markers in short-term mortality of septic patients with or without diabetes, particularly in terms of peripheral blood indicators. These findings must be verified and enhanced in future research.

Reference:

Wei, X., Min, Y., Yu, J., Wang, Q., Wang, H., Li, S., & Su, L. (2021). Admission Blood Glucose Is Associated With the 30-Days Mortality in Septic Patients: A Retrospective Cohort Study. In Frontiers in Medicine (Vol. 8). Frontiers Media SA. https://doi.org/10.3389/fmed.2021.757061