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Evaluation of glycemic control in critically ill patients with bacteremia: a retrospective, single-center cohort study
  1. Alaina Chou1,
  2. Rachael Carloni1,
  3. Wei Xue2,
  4. Vandana Seeram3,
  5. Jason A Ferreira1
  1. 1 Department of Pharmacy, UF Health Jacksonville, Jacksonville, Florida, USA
  2. 2 Department of Biostatistics, UF Health Shands Hospital, Gainesville, Florida, USA
  3. 3 Department of Pulmonary and Critical Care Medicine, UF Health Jacksonville, Jacksonville, Florida, USA
  1. Correspondence to Dr Jason A Ferreira, Department of Pharmacy, UF Health Jacksonville 655 West 8th Street, Clinical Center Basement C-89, Jacksonville, FL 32209, USA; jason.ferreira{at}jax.ufl.edu

Abstract

Dysglycemia is a common complication in hospitalized patients and has been suggested to play a significant role in the pathology and virulence of patients with bacteremia. The literature evaluating this relationship in critically ill patients, however, is limited. This retrospective, single-center cohort study aimed to investigate the relationship of glycemic control with 28-day intensive care unit (ICU)-free days in critically ill patients with bacteremia. Glycemic control was evaluated and determined based on time in targeted blood glucose range (TIR) of 70–140 mg/dL. Using a threshold of 80%, patients were then categorized into 2 groups: TIR-lo (<80%) and TIR-hi (≥80%). Unadjusted data identified a significant difference in ICU-free days (TIR-lo 21.29 days vs TIR-hi 24.08 days, p=0.007). However, due to an excess of zero ICU-free days, a zero-inflated Poisson model was used for analysis and demonstrated that patients in the TIR-lo group were 2.57 times more likely to have zero ICU-free days (p=0.033), which was attributed to mortality. Of the survivors, no difference was seen with TIR status and the number of ICU-free days (p=0.780). These findings demonstrate that glycemic control may increase the likelihood of being liberated from the ICU within a 28-day period, which the authors attributed to increased survival. However, of the patients who left the ICU, glycemic control was not associated with a significant difference in the number of ICU-free days.

  • blood glucose
  • diabetes mellitus
  • bacterial infections
  • critical care
  • disease management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors AC, RC. VS and JF conceived and planned the design and execution of this project. AC, RC and JC carried out the data structure and extraction. WX contributed to data preparation and analysis as well as interpretation . AC, RC. VS and JF contributed to the interpretation of the results. AC took the lead in writing the manuscript. JF acted as the gurantor. All authors provided critical feedback and helped shape the research, analysis and manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.