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Studies have found that both excessively high and low BG levels contribute to adverse cardiovascular events. Our study aims to investigate the optimal BG level for critically ill patients with cardiogenic shock and evaluate the effects of optimal BG on the prognosis of patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 2013 patients with cardiogenic shock obtained from the Medical Information Mart for Intensive Care (MIMIC) IV database were included in the final cohort for our retrospective observational study for data analysis. The exposure was time-weighted average BG (TWA-BG), which was calculated by the time-series BG records and corresponding time stamps of patients with cardiogenic shock during their stay in the ICU. The cut-off value of TWA-BG was identified by the restricted cubic spline curve and included patients were categorized into three groups: low TWA-BG group (TWA-BG\u2009\u2264\u2009104\u00a0mg\/dl), optimal TWA-BG group (104\u2009&lt;\u2009TWA-BG\u2009\u2264\u2009138\u00a0mg\/dl), and high TWA-BG group (TWA-BG\u2009&gt;\u2009138\u00a0mg\/dl). The primary outcome was 28-day mortality, and the secondary outcomes were ICU and in-hospital mortality. We performed the log-rank test to detect whether there is a difference in mortality among different groups in the original cohort. Multiple distinct models were employed to validate the robustness of the results.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Our study revealed that the optimal BG level for critically ill patients with cardiogenic shock is 104\u2013138\u00a0mg\/dl. Compared to the optimal TWA-BG group, the low TWA-BG group (hazard ratio (HR): 1.67, 95% confidence interval (CI): 1.19\u20132.33, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and high TWA-BG group (HR: 1.72, 95% CI: 1.46\u20132.03, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) exhibited higher 28-day mortality. Similarly, the low TWA-BG group and high TWA-BG group demonstrated higher risks in terms of ICU mortality (low TWA-BG group: HR: 2.30, 95% CI: 1.40\u20133.79, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; high TWA-BG group: HR: 1.77, 95% CI: 1.45\u20132.17, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and in-hospital mortality (low TWA-BG group: HR: 1.73, 95% CI: 1.19\u20132.51, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; high TWA-BG group: HR: 1.64, 95% CI: 1.38\u20131.95, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Sensitivity analysis conducted through propensity score matching and the subgroup analysis further substantiated the robustness of the results.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The optimal BG level for patients with cardiogenic shock is 104\u2013138\u00a0mg\/dl. BG levels below 104\u00a0mg\/dl and above 138\u00a0mg\/dl were associated with a less favorable prognosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40001-024-01724-8","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T07:02:34Z","timestamp":1708153354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The optimal blood glucose is significantly associated with lower mortality in critically ill patients with cardiogenic shock: an analysis revealed with time series blood glucose records"],"prefix":"10.1186","volume":"29","author":[{"given":"Ce","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Ling","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Le","family":"Ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Hui","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"issue":"2","key":"1724_CR1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1161\/CIRCOUTCOMES.115.002359","volume":"9","author":"RJ Goldberg","year":"2016","unstructured":"Goldberg RJ, Makam RCP, Yarzebski J, McManus DD, Lessard D, Gore JM. 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Informed written consent was waived by the Institutional Review Board at the Beth Israel Deaconess Medical Center as all patient information was deidentified (IRB #2001P001699). The need for obtaining consent to participate was waived owing to the retrospective and observational nature of the study in the MIMIC-IV database. Our team has been approved to access the MIMIC-IV database (Record ID 40974208).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. The need for obtaining consent for publication was waived owing to the retrospective and observational nature of the study in the MIMIC-IV database.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"129"}}