Glucose level and risk of mortality in pediatric septic shock.
OBJECTIVE
To study the relationship between serum glucose level and mortality in children with septic shock.


METHODS
Prospective cohort study.


METHODS
Twelve-bed pediatric intensive care unit at the Hospital São Lucas da PUCRS, Porto Alegre, Brazil.


METHODS
All children admitted with septic shock refractory to fluid therapy over a period of 32 months.


METHODS
None.


RESULTS
Serum glucose levels were measured in all children during the study period, and the highest value was assessed in relation to outcome. Fifty-seven of 1,053 children admitted to the intensive care unit were enrolled in the study. The peak glucose level in those with septic shock was 214 +/- 98 mg/dL (mean +/- SD), and the mortality rate was 49.1% (28/57). In nonsurvivors, the peak glucose level was 262 +/- 110 mg/dL, which was higher (p < .01) than that found in survivors (167.8 +/- 55 mg/dL). The area under the receiver operator curve for peak glucose level and mortality rate was 0.754. The best peak glucose level for predicting death in children with sepsis was 178 mg/dL (sensitivity, 0.714; specificity, 0.724), and the relative risk of death in patients with peak glucose levels of > or =178 mg/dL was 2.59 (range, 1.37-4.88).


CONCLUSIONS
In children with septic shock, a peak glucose level of >178 mg/dL is associated with an increased risk of death.
Paediatric Intensive Care Unit, Addenbrooke's Hospital, Cambridge, UK.
Ricardo G
RG
Branco
Pedro Celiny R
PC
Garcia
Jefferson P
JP
Piva
Carlos H
CH
Casartelli
Vanessa
V
Seibel
Robert C
RC
Tasker
D001786:Blood Glucose; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012306:Risk; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality*
D001786:Blood Glucose