A Study of Correlation Between Admission Hyperglycaemia and Outcomes in Critically Ill Patients

Introduction: Hyperglycaemia, both chronic and stress-induced forms, plays a significant role in determining outcomes for critically ill patients. Chronic hyperglycaemia, reflected by elevated HbA 1 c levels, contributes to a pro-inflammatory state, while stress-induced hyperglycaemia during acute illness increases the risk of poor outcomes. Novel metrics like the glycaemic gap and stress hyperglycaemia ratio (SHR) have shown promise in predicting clinical outcomes. This prospective observational study aimed to examine the relationship between admission hyperglycaemia and 30-day mortality in critically ill patients admitted to the intensive care unit (ICU) at a tertiary care centre in South India. Methods: A prospective observational study was conducted which included 200 patients who were admitted to the ICU. Key markers such as HbA 1 c, admission venous blood glucose, glycaemic gap, and SHR were assessed. The clinical course of the patients and 30-day mortality were monitored. Result: The study found significant correlations between an elevated glycaemic gap and SHR with increased 30-day mortality. The glycaemic gap cutoff of 45.49 mg/dL and SHR cutoff of 1.355 effectively predicted mortality, with high sensitivity and specificity. Elevated glycaemic gap and SHR were also associated with longer ICU stays, mechanical ventilation, and renal replacement therapy. Conclusion: The results suggest that glycaemic gap and SHR are reliable markers for predicting clinical outcomes in critically ill patients, with higher values correlating with poorer prognoses. These markers, in conjunction with blood glucose levels and HbA 1 c, can be used to assess disease severity and guide clinical management, especially in resource-limited settings.