Introduction and Objective: Emerging evidence suggests that glycemic variability may influence outcomes in sepsis. Our objective was to investigate the correlation between acute glycemic variability and mortality as well as other clinical outcomes in sepsis.Methods: Patients aged 18 years or older with sepsis were enrolled in this prospective observational study during 2024-2025. Capillary blood glucose was monitored every 4 hours for 48 hours. Acute glycemic variability (AGV) was assessed using standard deviation (SD), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Outcomes assessed were mortality at day 28, duration of ICU stay, length of hospital stay, ventilator support, and inotrope use.Results: A total of 151 patients were recruited (Age: 45.6±19.2 years; Male: 55.6%), 36.4% were diabetic. The mean admission SOFA score was 6.56±3.62. Median ICU and hospital stays were 6 days (IQR 4-9) and 8 days (IQR 5-17), respectively. Median durations of mechanical ventilation and oxygen therapy were 4 days (IQR 1-6) and 5 days (IQR 3-9), respectively.Non-survivors had significantly higher AGV than survivors, with higher SD (35.9±21.2 vs 29.7±19.6; p=0.035) and CV (22.9±10.2 vs 19.4±8.7; p=0.042). MAGE was higher among non-survivors but was statistically insignificant (76.2±54.4 vs 62.1±41.6; p=0.135).AGV was higher in diabetes than non-diabetic [SD (40.9±24.8 vs 25.7±14.2; p<0.001), CV (23.4±11.1 vs 18.5±7.4; p=0.017), and MAGE (84.4±57.0 vs 54.7±32.7; p=0.003)]. Higher SD and CV were associated with longer duration of oxygen requirement (p=0.04 and 0.005, respectively). None of the AGV (SD, CV, MAGE) could predict mortality in ROC curve analysis (p=0.216, p=0.397, p=0.70, respectively).Conclusion: In sepsis, increased AGV, particularly SD and CV, is associated with higher mortality and longer respiratory support. None of the AGVs could predict mortality.
S. Shukla: None. V.R. Pandit: None. J. Meher: None. J. Samanta: None. N. Agrawal: None.
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