Association between time in range of relative normoglycemia and in-hospital mortality in critically ill patients: a single-center retrospective study

The aim of this single-center retrospective study was to investigate the association between the time in range (TIR) of relative normoglycemia (RN) and in-hospital mortality. We defined RN as measured blood glucose in the range of 70-140% of A1C-derived average glucose and absolute normoglycemia (AN) as 70-140 mg/dL. We conducted multivariate logistic regression analyses to examine the association between TIR of RN > 80% or TIR of AN > 80% up to 72 h after ICU admission and in-hospital mortality (Model 1 and Model 2, respectively). The discrimination of the models was assessed using the area under the receiver operating characteristic curve (AUROC). Among 328 patients, 35 died in hospital (11%). Model 1 showed that TIR of RN > 80% was associated with reduced in-hospital mortality (adjusted OR 0.16; 95% CI 0.06-0.43; P < 0. 001); however, Model 2 showed that the TIR of AN > 80% was not. The AUROC of Model 1 was significantly higher than that of Model 2 (0.84 [95% CI 0.77-0.90] vs. 0.79 [0.70-0.87], P = 0.008).Our findings provide a foundation for further studies exploring individualized glycemic management in ICUs.

Automated summary

The aim of this study was to examine the association between the time in range of relative normoglycemia and in-hospital mortality. The findings suggest that maintaining a time in range of relative normoglycemia above 80% is associated with reduced in-hospital mortality.