Korean J Pediatr.  2010 Mar;53(3):323-328. 10.3345/kjp.2010.53.3.323.

Effect of hyperglycemia on mortality rates in critically ill children

• Kim S
• Kim BE
• Ha EJ
• Moon MY
• Park SJ

• KMID: 2281312
• DOI: http://doi.org/10.3345/kjp.2010.53.3.323

Abstract

PURPOSE
To verify the effect of hyperglycemia on mortality rates in critically ill children and to identify the blood glucose level that influences prognosis.
METHODS
From July 2006 to June 2008, a total of 206 patients who were admitted to the pediatric intensive care unit (PICU) at Asan Medical Center and who survived for more than 7 days were retrospectively reviewed. We analyzed the maximum glucose value within 7 days in PICU, PRISM-III score and SOFA score within 24 hours, and mortality. We did not perform an adjustment analysis of drugs affecting glucose level.
RESULTS
The maximum glucose level within 7 days in PICU was higher in the nonsurvival group than in the survival group. Using 4 cutoff values (125, 150, 175, and 200 mg/dL), the mortality of patients with hyperglycemia was found to be 13.0%, 14.4%, 19.8%, and 21.1%, respectively, and the cutoff values of 175 and 200 mg/dL revealed significant differences in mortalities between the hyperglycemic and normoglycemic groups. The PRISM-III score was not significantly different between the hyperglycemic and normoglycemic groups under a glucose cutoff value of 175 mg/dL, but the SOFA score was higher in the hyperglycemic group. Under a glucose cutoff value of 200 mg/dL, the PRISM-III score was higher in the hyperglycemic group, and the SOFA score did not differ between the 2 groups.
CONCLUSION
Hyperglycemia with a maximal glucose value > or = 175 mg/dL during the first 7 days after PICU admission was associated with increased mortality in critically ill children.

Keyword

Hyperglycemia; Child; Pediatric Intensive care unitm; Pediatric; Mortality; Survival

MeSH Terms

Blood Glucose
Child
Critical Illness
Glucose
Humans
Hyperglycemia
Intensive Care Units
Prognosis
Retrospective Studies
Blood Glucose
Glucose