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Pre-morbid glycemic control modifies the interaction between acute hypoglycemia and mortality

Overview of attention for article published in Intensive Care Medicine, February 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (78th percentile)
  • Good Attention Score compared to outputs of the same age and source (69th percentile)

Mentioned by

twitter
12 tweeters

Citations

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34 Dimensions

Readers on

mendeley
33 Mendeley
Title
Pre-morbid glycemic control modifies the interaction between acute hypoglycemia and mortality
Published in
Intensive Care Medicine, February 2016
DOI 10.1007/s00134-016-4216-8
Pubmed ID
Authors

Moritoki Egi, James S. Krinsley, Paula Maurer, Devendra N. Amin, Tomoyuki Kanazawa, Shruti Ghandi, Kiyoshi Morita, Michael Bailey, Rinaldo Bellomo

Abstract

To study the impact of pre-morbid glycemic control on the association between acute hypoglycemia in intensive care unit (ICU) patients and subsequent hospital mortality in critically ill patients. We performed a multicenter, multinational, retrospective observational study of patients with available HbA1c levels within the 3-month period preceding ICU admission. We separated patients into three cohorts according to pre-admission HbA1c levels (<6.5, 6.5-7.9, ≥8.0 %, respectively). Based on published data, we defined a glucose concentration of 40-69 mg/dL (2.2-3.8 mmol/L) as moderate hypoglycemia and <40 mg/dL (<2.2 mmol/L) as severe hypoglycemia. We applied logistic regression analysis to study the impact of pre-morbid glycemic control on the relationship between acute hypoglycemia and mortality. A total of 3084 critically ill patients were enrolled in the study. Among these patients, with increasing HbA1c levels from <6.5, to 6.5-7.9, and to ≥8.0 %, the incidence of both moderate (3.8, 11.1, and 16.4 %, respectively; p < 0.001) and severe (0.9, 2.5, and 4.3 %, respectively; p < 0.001) hypoglycemia progressively and significantly increased. The relationship between the occurrence of hypoglycemic episodes in the ICU and in-hospital mortality was independently and significantly affected by pre-morbid glucose control, as assessed by adjusted odds ratio (OR) and 95 % confidence interval (CI) for hospital mortality: (1) moderate hypoglycemia: in patients with <6.5, 6.5-7.9, and ≥8.0 % of HbA1c level-OR 0.54, 95 % CI 0.25-1.16; OR 0.82, 95 % CI 0.33-2.05; OR 3.42, 95 % CI 1.29-9.06, respectively; (2) severe hypoglycemia: OR 1.50, 95 % CI 0.42-5.33; OR 1.59, 95 % CI 0.36-7.10; OR 23.46, 95 % CI 5.13-107.28, respectively (interaction with pre-morbid glucose control, p = 0.009). We found that the higher the glucose level before admission to the ICU, the higher the mortality risk when patients experienced hypoglycemia. In critically ill patients, chronic pre-morbid hyperglycemia increases the risk of hypoglycemia and modifies the association between acute hypoglycemia and mortality.

Twitter Demographics

The data shown below were collected from the profiles of 12 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 33 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 3%
Brazil 1 3%
United States 1 3%
Unknown 30 91%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 15%
Student > Ph. D. Student 5 15%
Student > Postgraduate 4 12%
Other 4 12%
Researcher 3 9%
Other 12 36%
Readers by discipline Count As %
Medicine and Dentistry 18 55%
Unspecified 4 12%
Nursing and Health Professions 3 9%
Computer Science 3 9%
Arts and Humanities 2 6%
Other 3 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 December 2017.
All research outputs
#1,972,745
of 12,253,439 outputs
Outputs from Intensive Care Medicine
#891
of 3,156 outputs
Outputs of similar age
#61,825
of 286,716 outputs
Outputs of similar age from Intensive Care Medicine
#21
of 69 outputs
Altmetric has tracked 12,253,439 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,156 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.7. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 286,716 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 69 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.