Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20523
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dc.contributor.authorLuethi, Nora-
dc.contributor.authorCioccari, Luca-
dc.contributor.authorEastwood, Glenn M-
dc.contributor.authorBiesenbach, Peter-
dc.contributor.authorMorgan, Rhys-
dc.contributor.authorSprogis, Stephanie-
dc.contributor.authorYoung, Helen-
dc.contributor.authorPeck, Leah-
dc.contributor.authorKnee Chong, Christine-
dc.contributor.authorMoore, Sandra-
dc.contributor.authorMoon, Kylie-
dc.contributor.authorEkinci, Elif I-
dc.contributor.authorDeane, Adam M-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorMårtensson, Johan-
dc.date2019-03-18-
dc.date.accessioned2019-04-02T01:07:34Z-
dc.date.available2019-04-02T01:07:34Z-
dc.date.issued2019-07-
dc.identifier.citationActa Anaesthesiologica Scandinavica 2019; 63(6): 761-768en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/20523-
dc.description.abstractCritically ill patients with diabetes mellitus (DM) are at increased risk of in-hospital complications and the optimal glycemic target for such patients remains unclear. A more liberal approach to glucose control has recently been suggested for patients with DM, but uncertainty remains regarding its impact on complications. We aimed to test the hypothesis that complications would be more common with a liberal glycemic target in ICU patients with DM. Thus, we compared hospital-acquired complications in the first 400 critically ill patients with DM included in a sequential before-and-after trial of liberal (glucose target: 10-14 mmol/L) vs conventional (glucose target: 6-10 mmol/L) glucose control. Of the 400 patients studied, 165 (82.5%) patients in the liberal and 177 (88.5%) in the conventional-control group were coded for at least one hospital-acquired complication (P = 0.09). When comparing clinically relevant complications diagnosed between ICU admission and hospital discharge, we found no difference in the odds for infectious (adjusted odds ratio [aOR] for liberal-control: 1.15 [95% CI: 0.68-1.96], P = 0.60), cardiovascular (aOR 1.40 [95% CI: 0.63-3.12], P = 0.41) or neurological complications (aOR: 1.07 [95% CI: 0.61-1.86], P = 0.81), acute kidney injury (aOR 0.83 [95% CI: 0.43-1.58], P = 0.56) or hospital mortality (aOR: 1.09 [95% CI: 0.59-2.02], P = 0.77) between the liberal and the conventional-control group. In this prospective before-and-after study, liberal glucose control was not associated with an increased risk of hospital-acquired infectious, cardiovascular, renal or neurological complications in critically ill patients with diabetes.en_US
dc.language.isoeng-
dc.subjectClassification of Hospital Acquired Diagnoses (CHADx)en_US
dc.subjectIntensive careen_US
dc.subjectdiabetesen_US
dc.subjectglucose controlen_US
dc.subjectglycated haemoglobin A1cen_US
dc.subjecthypoglycaemiaen_US
dc.subjectin-hospital complicationsen_US
dc.subjectinsulinen_US
dc.titleHospital-acquired complications in intensive care unit patients with diabetes: A before-and-after study of a conventional versus liberal glucose control protocol.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleActa Anaesthesiologica Scandinavicaen_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationEndocrinologyen_US
dc.identifier.affiliationMedicine (University of Melbourne)en_US
dc.identifier.affiliationDepartment of Intensive Care Medicine, University Hospital, University of Bern, Bern, Switzerlanden_US
dc.identifier.affiliationSection of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Swedenen_US
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australiaen_US
dc.identifier.doi10.1111/aas.13354en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-1650-8939en_US
dc.identifier.orcid0000-0003-2372-395Xen_US
dc.identifier.orcid0000-0003-4197-8796en_US
dc.identifier.pubmedid30882892-
dc.type.austinJournal Article-
local.name.researcherBellomo, Rinaldo
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
crisitem.author.deptEndocrinology-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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