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首页> 外文期刊>Acute Medicine & Surgery >Impact of serum glucose levels on disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis
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Impact of serum glucose levels on disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis

机译：血清血糖水平对严重脓毒症患者疾病严重程度和结果的影响：来自多中心的分析，对严重脓毒症的前瞻性调查

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Aim To determine whether glycemic abnormality and pre‐existing diabetes are associated with disease severity and mortality in patients with severe sepsis. Methods Six hundred and nineteen patients with severe sepsis were grouped into four categories according to their blood glucose levels (100, 100–199, 200–299, and ≥300?mg/d L ). We compared disease severity and mortality between glycemic categories. In addition, we examined whether there was any relationship with pre‐existing diabetes status. Results There were no significant differences in disseminated intravascular coagulation, S equential O rgan F ailure A ssessment, or A cute P hysiology and C hronic H ealth E valuation II scores and mortality rates between patients with or without pre‐existing diabetes. However, in patients without pre‐existing diabetes, those with blood glucose level 100?mg/d L had higher disseminated intravascular coagulation, S equential O rgan F ailure A ssessment, and A cute P hysiology and C hronic H ealth E valuation II scores than those with levels of 100–299?mg/d L . In addition, those with level ≥300?mg/d L had a higher hospital mortality rate than those with levels of 100–199?mg/d L (odds ratio?=?4.837). Multivariate logistic regression analysis revealed that a blood glucose level ≥300?mg/d L is an independent predictor of hospital mortality in these patients. In contrast, no significant differences among severity scores or mortality were observed in patients with pre‐existing diabetes. Conclusions In patients with severe sepsis, the impact of glycemic abnormality on disease severity and hospital mortality depends on the pre‐existing diabetes status. Specifically, a blood glucose level ≥300?mg/d L may be associated with increased mortality in patients without pre‐existing diabetes.
机译：目的旨在确定血糖异常和预先存在的糖尿病是否与严重败血症患者的疾病严重程度和死亡率有关。方法根据血糖水平（<100,100-199,299，≥300μmg/ d），将六百九十九九患者分为四类分为四类。我们比较了血糖类别之间的疾病严重程度和死亡率。此外，我们检查了是否存在与患有预先存在的糖尿病身份的关系。结果弥散血管内凝血的血管内凝固无显着差异，或者在患有或不含预先存在的糖尿病的患者之间的分数和死亡率，或者没有预先存在的糖尿病患者的患者的分数和死亡率，没有显着差异。然而，在没有预先存在的糖尿病的患者中，血糖水平<100？mg / d L的患者具有更高的血管内凝血，S交通o rgan f ailure a ssessment，以及可爱的p毒蕈学和c hronic health e估值II比那些水平为100-299的分数？mg / d l。此外，具有≥300℃的人的医院死亡率高于100-199×mg / d l（差距率Δ= 4.837）的高度。多变量逻辑回归分析显示，血糖水平≥300？Mg / D L是这些患者的医院死亡率的独立预测因子。相比之下，在预先存在的糖尿病患者中观察到严重程度或死亡率之间没有显着差异。结论患有严重脓毒症的患者，血糖异常对疾病严重程度和医院死亡率的影响取决于预先存在的糖尿病状态。具体而言，血糖水平≥300μmβmg/ d L可能与没有预先存在的糖尿病的患者的死亡率增加。

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