Glycaemic penalty index as an independent predictor of healthcare-associated infection in surgical inpatients: A nested cohort study from the STOIC-D surgery trial.
Gabrielle Blomson, Rahul D Barmanray, Mervyn Kyi et al.
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In 30 seconds
This nested cohort study examined whether the Glycemic Penalty Index (GPI), summarised as patient-day weighted mean GPI (PDWMGPI), was associated with adverse outcomes in 691 surgical inpatients with diabetes receiving standard care at a quaternary Australian hospital. Data came from the control arm of the STOIC-D Surgery randomised trial. In multivariable analysis, higher PDWMGPI was independently associated with healthcare-associated infection (odds ratio 1.02 per one-unit increase, 95% CI 1.01-1.04, p = 0.008). The abstract reports no association estimate for acute kidney injury.
Key findings
- Higher PDWMGPI was independently associated with healthcare-associated infection: odds ratio 1.02 per one-unit increase, 95% CI 1.01-1.04, p = 0.008.
- The analysis included 691 surgical inpatients with diabetes receiving standard care.
Why it matters
A single summary score of inpatient glycaemic patterns may help identify surgical inpatients with diabetes who have greater infection risk. The observed association supports further consideration of GPI as a risk-stratification aid, interpreted alongside clinical factors; it does not establish that changing the score or glycaemia would prevent infection.
What to keep in mind
This was a nested cohort analysis of the trial’s control arm, not a randomised test of GPI-guided care. The abstract reports an association with infection but provides no effect estimate for acute kidney injury.