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Glycemic control, diabetic status, and mortality in a heterogeneous population of critically ill patients before and during the era of intensive glycemic management: six and one-half years experience at a university-affiliated community hospital.
Semin Thorac Cardiovasc Surg. 2006 Winter; 18(4):317-25.ST

Abstract

Hyperglycemia occurs commonly in acutely and critically ill patients and has been associated with adverse clinical consequences. An emerging body of literature describes the beneficial effects of intensive glycemic monitoring and treatment (tight glycemic control, or "TGC"). This manuscript reviews the experience of a cohort of 5365 non-cardiac surgery patients admitted to the adult intensive care unit of a university-affiliated community hospital before and after implementation of TGC. Significant decreases in mortality occurred among medical and surgical patients during the TGC era, but not among trauma patients. Non-diabetics who sustained hyperglycemia had an especially high risk of mortality, and benefited greatly from treatment. Further investigations will be needed to identify the most appropriate glycemic targets for different populations of patients.

Authors+Show Affiliations

Stamford Hospital, Columbia University College of Physicians and Surgeons, Stamford, CT 06902, USA. jkrinsley@stamhealth.org

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17395028

Citation

Krinsley, James S.. "Glycemic Control, Diabetic Status, and Mortality in a Heterogeneous Population of Critically Ill Patients Before and During the Era of Intensive Glycemic Management: Six and One-half Years Experience at a University-affiliated Community Hospital." Seminars in Thoracic and Cardiovascular Surgery, vol. 18, no. 4, 2006, pp. 317-25.
Krinsley JS. Glycemic control, diabetic status, and mortality in a heterogeneous population of critically ill patients before and during the era of intensive glycemic management: six and one-half years experience at a university-affiliated community hospital. Semin Thorac Cardiovasc Surg. 2006;18(4):317-25.
Krinsley, J. S. (2006). Glycemic control, diabetic status, and mortality in a heterogeneous population of critically ill patients before and during the era of intensive glycemic management: six and one-half years experience at a university-affiliated community hospital. Seminars in Thoracic and Cardiovascular Surgery, 18(4), 317-25.
Krinsley JS. Glycemic Control, Diabetic Status, and Mortality in a Heterogeneous Population of Critically Ill Patients Before and During the Era of Intensive Glycemic Management: Six and One-half Years Experience at a University-affiliated Community Hospital. Semin Thorac Cardiovasc Surg. 2006;18(4):317-25. PubMed PMID: 17395028.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glycemic control, diabetic status, and mortality in a heterogeneous population of critically ill patients before and during the era of intensive glycemic management: six and one-half years experience at a university-affiliated community hospital. A1 - Krinsley,James S, PY - 2006/12/27/accepted PY - 2007/3/31/pubmed PY - 2007/6/30/medline PY - 2007/3/31/entrez SP - 317 EP - 25 JF - Seminars in thoracic and cardiovascular surgery JO - Semin Thorac Cardiovasc Surg VL - 18 IS - 4 N2 - Hyperglycemia occurs commonly in acutely and critically ill patients and has been associated with adverse clinical consequences. An emerging body of literature describes the beneficial effects of intensive glycemic monitoring and treatment (tight glycemic control, or "TGC"). This manuscript reviews the experience of a cohort of 5365 non-cardiac surgery patients admitted to the adult intensive care unit of a university-affiliated community hospital before and after implementation of TGC. Significant decreases in mortality occurred among medical and surgical patients during the TGC era, but not among trauma patients. Non-diabetics who sustained hyperglycemia had an especially high risk of mortality, and benefited greatly from treatment. Further investigations will be needed to identify the most appropriate glycemic targets for different populations of patients. SN - 1043-0679 UR - https://www.unboundmedicine.com/medline/citation/17395028/Glycemic_control_diabetic_status_and_mortality_in_a_heterogeneous_population_of_critically_ill_patients_before_and_during_the_era_of_intensive_glycemic_management:_six_and_one_half_years_experience_at_a_university_affiliated_community_hospital_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1043-0679(07)00002-0 DB - PRIME DP - Unbound Medicine ER -