Prevalence of stress hyperglycemia among patients attending a pediatric emergency department.
OBJECTIVE
To determine the prevalence and clinical characteristics associated with stress hyperglycemia among children and adolescents attending a pediatric emergency department.


METHODS
Patients who required a venipuncture for evaluation of an acute illness or injury from October 1992 to March 1993 in an urban pediatric emergency department were enrolled and screened prospectively for hyperglycemia (glucose level > or = 8.3 mmol/L; > or = 150 mg/dl). Data were collected regarding demographic characteristics, history, clinical findings, and admission status.


RESULTS
A total of 926 patients ranging in age from 3 days to 21 years were enrolled. Blood glucose values ranged from 1.94 mmol/L (35 mg/L) to 14.65 mmol/L (264 mg/dl); 35 patients (3.8%) had hyperglycemia. The prevalence of stress hyperglycemia was significantly increased among patients if they (1) had temperatures greater than 39.5 degrees C (9.3%) versus normal temperatures (2.8%) (p < 0.001), (2) had been admitted to a critical care unit of the hospital (24.1%) or to any hospital unit (4.4%) versus not having been admitted (2.6%) (p < 0.001), and (3) had received fluids intravenously (6.0%) versus having received no fluids intravenously (2.7%) (p = 0.014).


CONCLUSIONS
Stress hyperglycemia is a frequent clinical occurrence in a pediatric emergency department. It does not appear to be associated with a particular diagnostic category but is significantly associated with severity of illness as measured by elevated temperature, hospital admission, and hydration status.
Bhisitkul
D M
DM
Division of Pediatric Emergency Medicine, Children's Hospital of the King's Daughters, Norfolk, VA 23507.
Morrow
A L
AL
Vinik
A I
AI
Shults
J
J
Layland
J C
JC
Rohn
R
R
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006786:Hospitals, Urban; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013312:Stress, Physiological / Q000097:blood / Q000150:complications*
D001786:Blood Glucose