All issues > Volume 53(3); 2010

Original Article

Korean J Pediatr. 2010;53(3):323-328. Published online March 15, 2010.

Effect of hyperglycemia on mortality rates in critically ill children

Seongkuk Sk Kim¹, Bo Eun BE Kim¹, Eun Ju EJ Ha¹, Mi Young MY Moon², Seong Jong SJ Park¹

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
²Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence Seong Jong SJ Park ,Email: drpsj@amc.seoul.kr

Received: March 11, 2009; Revised: July 13, 2009   Accepted: January 13, 2010.

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 ≥175 mg/dL during the first 7 days after PICU admission was associated with increased mortality in critically ill children.

Keywords :Hyperglycemia, Glucose, Children, Pediatrics, Pediatric intensive care, Mortality, Survival