Prevalence and Clinical Outcome of Inpatient Hyperglycemia in a Community Pediatric Hospital

• Type of Material: Article
• Authors: Andres Palacio, Emory University; Miguel Ceron, Emory University; Robin Klein, Emory University; Irene S. Cho, Emory University; Dawn Smiley, Emory University; Roberto Mejia, Emory University; Guillermo Umpierrez, Emory University
• Language: English
• Date: 2008-05
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2008 Society of Hospital Medicine
• Final Published Version (URL): http://onlinelibrary.wiley.com/doi/10.1002/jhm.309/abstract
• Title of Journal or Parent Work: Journal of Hospital Medicine
• ISSN: 1553-5592
• Volume: 3
• Issue: 3
• Start Page: 212
• End Page: 217
• Grant/Funding Information: Dr Umpierrez is supported by research grants from the American Diabetes Association (7-03-CR-35), American Heart Association (0555306B), and National Institutes of Health: R03 DK073190-01 and General Clinical Research Center Grant M01 RR-00039.
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, General

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 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 the hospital stay. In the remaining patients, we determined the prevalence of hyperglycemia and examined the association of hyperglycemia and clinical outcome. Results A total of 406 patients (75%) had an admission blood glucose ≤ 120 mg/dl [(mean 98 ± 1 mg/dl (± SEM)], 103 children (19%) had an admission blood glucose level between 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<0.001) and had a longer length of ICU stay (p<0.001), but admission hyperglycemia was not associated with longer hospital stay or higher hospital mortality. Summary 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.