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 sea...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 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.展开更多
文摘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 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.
