Association of 24 hour mean blood glucose levels with mortality in patients with acute pancreatitis

This study aims to investigate the impact of 24 hour mean blood glucose (24h MBG) levels on the mortality of patients hospitalized with acute pancreatitis (AP) and to explore the clinical implications of this association. A retrospective examination of clinical datasets of AP patients was performed using the Medical Information Mart for Intensive Care-IV database. The optimal 24h MBG levels threshold was determined by the X-tile tool. Univariate and multivariate logistic regression analyses were used to assess the prognostic significance of 24h MBG levels. A survival analysis was carried out, and Kaplan-Meier survival curves were constructed to show survival probabilities over time. To strengthen result validity and reduce covariate confounding, a 1:1 propensity score matching (PSM) technique was implemented. An external validation was also performed with a cohort of 766 AP patients from the eICU database. A total of 977 subjects were enrolled in this study. The 24h MBG level's optimal cutoff for predicting in-hospital mortality was determined to be 146 mg/dL. Following PSM analysis, 336 pairs of subjects were identified, achieving equilibrium in most baseline characteristics. Kaplan-Meier survival analysis demonstrated that patients with 24h MBG of 146 mg/dL or higher exhibited significantly elevated rates of in-hospital, 30-day, and 90-day mortality compared to those with 24h MBG below 146 mg/dL (P < .05). Multivariate logistic regression analysis, after adjusting for potential confounding factors, indicated that patients with 24h MBG of 146 mg/dL or higher had a markedly increased odds of in-hospital mortality relative to those with a mean BG below 146 mg/dL (odds ratio = 3.9, 95% confidence interval: 1.86~8.21, P < .001). Consistent results were observed in the PSM-adjusted cohort. Our findings indicate a significant correlation between 24h MBG levels and mortality in patients who have suffered from AP. The results presented in this study are significant and emphasize the necessity for healthcare providers to take into account the impact of 24h MBG levels in effectively managing mortality.