Time in targeted blood glucose range as an independent predictor of 28-Day mortality in ICU Patients: A retrospective study

Abstract

Objective: This study aimed to evaluate the relationship between time in targeted blood glucose range (TIR) and 28-day mortality in critically ill patients.

Methods: A retrospective cohort analysis was conducted using data from the MIMIC-IV database. Patients (n = 18,905) were stratified into four quartiles based on TIR values. The association between TIR and mortality was assessed using multivariable logistic regression models with adjustments for potential confounders.

Results: In the fully adjusted model, each percentage point increase in TIR was associated with a 1 % reduction in 28-day mortality risk (OR = 0.99, 95 % CI: 0.98-0.99, P < 0.001). Patients in the highest TIR quartile showed a 60 % lower mortality risk compared to those in the lowest quartile (OR = 0.40, 95 % CI: 0.22-0.74, P = 0.003). The predictive model demonstrated good discriminative ability (AUC = 0.7543).

Conclusion: Time in targeted blood glucose range is independently associated with 28-day mortality in ICU patients, suggesting its potential value as a metric for risk stratification and glycemic management optimization.

Keywords: Blood Glucose Control; Critical Care; ICU Mortality; Predictive Modeling; Retrospective Study; Time in Targeted Blood Glucose Range.