Correlation between hyperglycemia and mortality in a medical and surgical intensive care unit.

The aim of this study was to assess the correlation between hyperglycemia and mortality in a group of patients admitted to a medical and surgical ICU and to evaluate if the association between hyperglycemia and reason of ICU admission significantly worsens patients' outcomes.A retrospective clinical study was conducted in the ICU of a University Hospital. Four-hundred and twelve adult patients admitted to our ICU were enrolled. The blood glucose level was measured at the time of admission and daily at 2-4 h intervals. When the glucose level exceeded 180 mg/dL, an insulin bolus or a continuous infusion were performed to maintain the glucose level at or below 180-200 mg/dL.Analysing the mean blood glucose levels of patients with the receiver operating characteristic (ROC) curve, it resulted that the blood glucose level of 141.7 mg/dL had higher sensitivity (76%) and specificity (56.5%) to discriminate the probability of death. In other words, in patients in whom the mean blood glucose levels were greater than 141.7 mg/dL, the probability of death was higher (26.62%) than in the group of patients in whom a strict blood glucose control was maintained (13.55%) (P = 0.0017).A strict blood glucose control seems to be crucial, even in a medical and surgical ICU. The need for intensive insulin therapy, even by means of continuous infusion of insulin, to obtain the normalization of blood glucose levels, appears essential.