The impact of admission blood glucose on the prognosis of patients with acute coronary syndrome in the intensive care unit——based on data from the MIMIC-Ⅳ 2.0 database in the United States
Objective:To investigate the impact of admission blood glucose on the prognosis of patients with acute coro-nary syndrome(ACS)in the intensive care unit(ICU).Methods:We retrospectively collected data from patients with ACS who were first admitted to the ICU and met the study requirements in the MIMIC-IV 2.0 database.The restricted cubic spline(RCS)model was used to evaluate the association between admission blood glucose and prognosis of patients with ACS at the continuous level.The patients were divided into four groups based on their admission blood glucose using the quartile meth-od,and the impact of admission blood glucose on ACS patient prognosis was analyzed using a multivariate Cox regression model.In addition,a stratified analysis was performed on the nonlinear relationship between admission blood glucose and 90-day mortality according to gender,age,and the presence or absence of diabetes.Results:There was a significant nonlin-ear relationship between admission blood glucose and mortality in ACS patients.When blood glucose ≤ 107 mg/dL(5.94 mmol/L),the risk of death decreased with increasing blood glucose.When 107 mg/dL＜blood glucose≤ 244 or 242 mg/dL(13.56 or 13.43 mmol/L),the risk of death increased with increasing blood glucose.When 107 mg/dL＜blood glucose≤ 244 or 242 mg/dL,the risk of death remained stable at a high level.The multivariate Cox regression results showed that patients in the fourth quartile of blood glucose had the highest risk of death.Conclusion:Our study demonstrates a significant nonlinear relationship between admission blood glucose and mortality in ACS patients,indicating the optimal blood glucose level for minimizing the risk of death,providing a reference for blood glucose regulation in ACS patients.
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