Prevalence and clinical outcome of inpatient hyperglycemia in a community pediatric hospital

Abstract

BACKGROUND:Inpatient hyperglycemia in adult patients with and without a history of diabetes is a predictor of poor clinical outcome. No previous studies, however, have examined the association of hyperglycemia and clinical outcome in children admitted to a community pediatric hospital.METHODS:The study was a retrospective observational cohort of pediatric patients admitted to a community children's hospital from January 2004 to August 2004. Medical records of 903 consecutive children admitted to critical and non–critical care areas were reviewed. Of them, 342 patients (38%) had no blood glucose measurements during their hospital stay. In the remaining patients, we determined the prevalence of hyperglycemia and examined the association of hyperglycemia with clinical outcome.RESULTS:A total of 406 patients (75%) had an admission blood glucose ≤120 mg/dL (mean ± SEM 98 ± 1 mg/dL), 103 children (19%) had an admission blood glucose level of 121–179 mg/dL (mean 143 ± 2 mg/dL), and 32 patients (5.9%) had a blood glucose level ≥180 mg/dL (mean 260 ± 18 mg/dL). Seventeen patients (13%) had a known history of diabetes prior to admission. Children with hyperglycemia were more likely to be admitted to the ICU (P < .001) and had a longer length of ICU stay (P < .001), but admission hyperglycemia was not associated with longer hospital stay or higher hospital mortality.CONCLUSIONS:Hyperglycemia is present in one‐fourth of children admitted to the hospital, most of them without a history of diabetes prior to admission. Hyperglycemia was associated with a greater need for ICU care and longer ICU stay but not with increased in‐hospital mortality. Journal of Hospital Medicine 2008;3:212–217. © 2008 Society of Hospital Medicine.

A retrospective analysis of dysglycaemia and its risk factors in a cohort of human immunodeficiency virus infected antiretroviral therapy naïve children in Makurdi, Nigeria

“…Among paediatric admissions into hospitals, the prevalence of hyperglycaemia of 8.2% in the present study was lower than 10.9% reported by Sambany et al in Magadascar 29 , the 25% by Palacio et al in Atlanta, USA 31 , but was higher than the 2.7% reported by Osier et al in Kenya 30 . The various definitions ascribed to hyperglycaemia could explain the different prevalence of hyperglycaemia in our study and those of others [29][30][31] .…”

“…The various definitions ascribed to hyperglycaemia could explain the different prevalence of hyperglycaemia in our study and those of others [29][30][31] . Whilst we used ˃ 6.6 mmol/l as a cut-off value for hyperglycaemia in our own study, it was ˃8.3 mmol/l, ˃7.1 mmol/l and ˃10mmol/l in the studies in Madagascar, Atlanta and Kenya respectively.…”

“…Whilst we used ˃ 6.6 mmol/l as a cut-off value for hyperglycaemia in our own study, it was ˃8.3 mmol/l, ˃7.1 mmol/l and ˃10mmol/l in the studies in Madagascar, Atlanta and Kenya respectively. Also, the different spectrum of diseases among our HIV-infected ARTnaive children and the children in other settings [29][30][31] could also explain the varying burden of hyperglycaemia.…”

“…Normoglycaemia was blood glucose between 2.2-6.6 mmol/l (40-120 mg/ dl) and hyperglycaemia was blood glucose over 6.6 mmol/l (>120 mg/ dl) 31,32 . Abnormal blood glucose, or dysglycaemia, was defined as any of these 2 categories above.…”

Childhood Dysglycemia: Prevalence and Outcome in a Referral Hospital

“…In an American study in a community pediatric hospital, hyperglycemia was associated with a greater need for intensive care and ICU monitoring but not with increased in-hospital mortality [44]. In a similar study, the frequency of hyperglycemia was evaluated at 14.3% for children admitted to intensive care centers without any association between hyperglycemia and mortality [45].…”