Intensive Insulin Therapy and Mortality in Critically Ill Patients
Author Information
Author(s): Treggiari Miriam M, Karir Veena, Yanez N David, Weiss Noel S, Daniel Stephen, Deem Steven A
Primary Institution: University of Washington
Hypothesis
Does intensive insulin therapy reduce mortality in a mixed population of critically ill patients?
Conclusion
Intensive insulin therapy was not associated with a decrease in hospital mortality and may be linked to increased mortality in certain subgroups.
Supporting Evidence
- Insulin administration increased over time from 9% to 42% across the study periods.
- Patients in period III had a tendency toward higher adjusted hospital mortality compared to period I.
- The incidence of hypoglycemia increased approximately fourfold from periods I to III.
- Adjusted odds ratios indicated no significant difference in hospital mortality between periods II and III compared to period I.
Takeaway
This study looked at whether giving a lot of insulin to very sick patients helps them live longer, but it found that it didn't help and might even make things worse for some.
Methodology
A cohort study comparing three time periods before and after implementing an intensive insulin therapy protocol in a Level 1 trauma center.
Potential Biases
Potential bias remains despite adjustments for patient characteristics.
Limitations
The study may have bias despite controlling for confounding factors, and it did not achieve the targeted glucose levels consistently.
Participant Demographics
The study included a mixed population of critically ill patients, with a significant proportion being trauma patients.
Statistical Information
P-Value
0.007
Confidence Interval
95% CI 1.11, 1.93
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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