Glycaemic Variability in Critically ill Patients: Association with ICU Mortality and Length of Stay

Abstract

Background: Blood glucose (BG) homeostasis is frequently disrupted in critically ill patients. While hyperglycaemia and hypoglycaemia are established risk factors, Glycemic Variability (GV) the degree of glucose fluctuation is emerging as a critical independent predictor of mortality. Objective: To determine the incidence of hyperglycaemia, hypoglycaemia, and GV and to evaluate their specific associations with ICU mortality, length of stay (LOS). Methods: This prospective observational study followed 50 adult patients in a combined medical-surgical ICU at a tertiary care center at Hahc hospital, New Delhi. BG was monitored via arterial sampling. GV was defined as the presence of both hyperglycaemia (>180 mg/dl) and hypoglycaemia (<60 mg/dl) during the ICU stay. Results: Hyperglycaemia (60%), hypoglycaemia (68%), and GV (52%) were prevalent. Mortality was 46%. All non-survivors (100%) experienced hyperglycaemia, and 95.6% exhibited high GV. Statistical analysis showed a profound correlation between GV and mortality. Conclusion: GV is a superior predictor of mortality compared to mean glucose levels and is strongly associated with prolonged ICU stay and increased infection rates.

Keywords: Glycaemic Variability; Critical Illness; Intensive Care Unit; Hyperglycaemia; Hypoglycaemia; ICU Mortality; Length of Stay.