Relationship between hypoglycemia and mortality in critically ill children

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Edward Vincent S Faustino, Clifford W Bogue

Abstract

To determine the prevalence of hypoglycemia in critically ill nondiabetic children and the association of hypoglycemia with mortality and worsening organ function in critically ill children. Retrospective cohort study with matched-cohort analysis. Academic pediatric intensive care unit. A total of 899 nondiabetic patients <18 yrs old admitted to the pediatric intensive care unit for >1 day with at least one blood glucose measurement. Forty-two patients with a blood glucose level of <50 mg/dL (<2.8 mmol/L) were matched with 126 nonhypoglycemic patients. None. Hypoglycemia, based on point-of-care blood glucose measurements, occurred in 2.2% (<40 mg/dL [<2.2 mmol/L]) to 7.5% (<60 mg/dL [<3.3 mmol/L]) of the patients. Hypoglycemia was more common in patients on mechanical ventilation and/or vasopressor support. Severity of hypoglycemia correlated with an increased mortality rate. The highest odds ratio of mortality was 4.49 (95% confidence interval [CI], 1.69-11.96; p < .01) at a blood glucose level of <40 mg/dL (<2.2 mmol/L). In the matched analysis, hypoglycemia was an independent risk factor for mortality. The unadjusted, covariate-adjusted, and propensity score-adjusted odds ratios of mortality were 3.69 (95% CI, 1.78-7.68; p <...Continue Reading

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