PMID- 22333549
OWN - NLM
STAT- MEDLINE
DCOM- 20120802
LR  - 20120215
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 91
IP  - 40
DP  - 2011 Nov 1
TI  - [Values of glycemic lability index in the prognostic evaluation of critically ill 
      patients in intensive care unit].
PG  - 2853-7
AB  - OBJECTIVE: To access the predictive values of glycemic lability index (GLI) as an 
      indicator of glucose variability in the prognosis of critically ill patients. 
      METHODS: A prospective study of 72 critically ill patients admitted into 
      intensive care unit (ICU) were performed. Capillary glucose was measured on 
      admission and every 2 hrs afterward during the first 24 hrs. GLI, mean amplitude 
      of glycemic excursion (MAGE), largest amplitude of glycemic excursions (LAGE), 
      mean, standard deviation (SD) and coefficient of variability (CV) were calculated 
      respectively. The 30 day mortality was selected as the end-point. Receiver 
      operating curve (ROC) was drawn to explore the association between each indicator 
      of glucose variability and prognosis. The subjects were subsequently divided into 
      4 subgroups according to the median of mean and GLI. The 30-day mortality was 
      then compared between the subgroups. RESULTS: Thirty-one of 72 patients died with 
      a mortality rate of 43.1%. The area under the curve (AUC) of GLI (0.798 +/- 0.051) 
      was superior to that of MAGE (0.785 +/- 0.053), LAGE (0.772 +/- 0.056), SD (0.761 +/- 
      0.056), CV (0.729 +/- 0.059) and mean (0.670 +/- 0.065) under the determination of 
      ROC respectively. GLI was significantly correlated with APACHE II (acute 
      physiology and chronic health evaluation II) score assessed during the first 24 
      hrs after admission (R(2) = 0.787, P < 0.001). With the rise of GLI value, the 
      30-day mortality also increased gradually. Subgroup analysis demonstrated that 
      the duration of mechanical ventilation, the incidence of multiple organ failure 
      (MOF), the utilization rate of CRRT (continuous renal replacement therapy), the 
      staying length of ICU and the 30 mortality rate was (3.3 +/- 4.4) d, 41.6%, 12.5%, 
      (4.6 +/- 4.5) d and 16.7% respectively in the low mean +low GLI subgroup. They 
      decreased obviously compared to the low mean +high GLI, high mean +low GLI and 
      high mean +high GLI groups. Therefore the low mean +low GLI subgroup had the best 
      prognosis while the high mean +high GLI subgroup worst. CONCLUSION: GLI of the 
      first 24 hrs after ICU admission can serve as an indicator of glucose 
      variability. And it is significantly correlated with the patient prognosis.
FAU - Cai, Yan
AU  - Cai Y
AD  - Department of Critical Care Medicine, Affiliated People's Hospital, Jiangsu 
      University, Zhenjiang 212002, China.
FAU - Ma, Gui
AU  - Ma G
FAU - Jin, Zhao-chen
AU  - Jin ZC
FAU - Zhang, Wen-bo
AU  - Zhang WB
FAU - Jiang, Peng-cheng
AU  - Jiang PC
LA  - chi
PT  - English Abstract
PT  - Journal Article
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Glucose/*analysis
MH  - *Critical Illness
MH  - Female
MH  - *Glycemic Index
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Survival Rate
EDAT- 2012/02/16 06:00
MHDA- 2012/08/03 06:00
CRDT- 2012/02/16 06:00
PHST- 2012/02/16 06:00 [entrez]
PHST- 2012/02/16 06:00 [pubmed]
PHST- 2012/08/03 06:00 [medline]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2011 Nov 1;91(40):2853-7.