TY - JOUR
T1 - A meta-analysis of tight versus conventional glycemic control in critically ill brain injured adults
AU - Lei, Qi
AU - Maode, Wang
AU - Xin, Liu
AU - Tuo, Wang
AU - Gaofeng, Xu
AU - Qi, Li
AU - Ruichun, Li
PY - 2012/2
Y1 - 2012/2
N2 - Objective: To evaluate the benefits and risks of tight glycemia control (TGC) versus conventional glucose control (CGC) in critically ill brain injured adults. Methods: We performed meta-analysis by systematically searching PubMed, EMBASE, OVID, ScienceDirect, Web of Science, CNKI, Wanfang Data, and CQVIP databases to retrieve RCTs in any languages. We used Review Manager to perform meta-analysis. Odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated in analyses. Results: Twenty six RCTs with a total of 3,759 participants were included in this meta-analysis. In-hospital mortality showed significant dissimilarity between TGC and CGC groups with OR of 0.76 (95% CI 0.58, 0.99). However, in terms of overall mortality and long term neurological severity outcome, it didn't show differences with ORs of 0.93 (95% CI 0.79, 1.10) and 1.15 (95% CI 0.96, 1.37). There were also discrepancies in infection rate and ICU length of stay (LOS) with OR of 0.51 (95% CI 0.42, 0.62) and WMD of -2.37 (95% CI -2.99, -1.74). Significances were observed in hypoglycemia events with ORs of 6.24 (95% CI 4.83, 8.07) and 2.73 (95% CI 2.56, 2.91) using two methods. Conclusion: In critically ill brain injury, TGC did not show beneficial effects on reducing overall mortality and long term neurological outcome, but it increased the risk of hypoglycemia.
AB - Objective: To evaluate the benefits and risks of tight glycemia control (TGC) versus conventional glucose control (CGC) in critically ill brain injured adults. Methods: We performed meta-analysis by systematically searching PubMed, EMBASE, OVID, ScienceDirect, Web of Science, CNKI, Wanfang Data, and CQVIP databases to retrieve RCTs in any languages. We used Review Manager to perform meta-analysis. Odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated in analyses. Results: Twenty six RCTs with a total of 3,759 participants were included in this meta-analysis. In-hospital mortality showed significant dissimilarity between TGC and CGC groups with OR of 0.76 (95% CI 0.58, 0.99). However, in terms of overall mortality and long term neurological severity outcome, it didn't show differences with ORs of 0.93 (95% CI 0.79, 1.10) and 1.15 (95% CI 0.96, 1.37). There were also discrepancies in infection rate and ICU length of stay (LOS) with OR of 0.51 (95% CI 0.42, 0.62) and WMD of -2.37 (95% CI -2.99, -1.74). Significances were observed in hypoglycemia events with ORs of 6.24 (95% CI 4.83, 8.07) and 2.73 (95% CI 2.56, 2.91) using two methods. Conclusion: In critically ill brain injury, TGC did not show beneficial effects on reducing overall mortality and long term neurological outcome, but it increased the risk of hypoglycemia.
KW - Brain injury
KW - Critical care
KW - Glycemia
KW - Meta-analysis
UR - https://www.scopus.com/pages/publications/84859851632
U2 - 10.1016/S1000-1948(12)60003-3
DO - 10.1016/S1000-1948(12)60003-3
M3 - 文章
AN - SCOPUS:84859851632
SN - 1000-1948
VL - 27
SP - 20
EP - 37
JO - Journal of Medical Colleges of PLA
JF - Journal of Medical Colleges of PLA
IS - 1
ER -