Prevalence and clinical outcome of inpatient hyperglycemia in a community pediatric hospital.
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
The study was a 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 their hospital stay. In the remaining patients, we determined the prevalence of hyperglycemia and examined the association of hyperglycemia with clinical outcome.


RESULTS
A total of 406 patients (75%) had an admission blood glucose < or =120 mg/dL (mean +/- SEM 98 +/- 1 mg/dL), 103 children (19%) had an admission blood glucose level of 121-179 mg/dL (mean 143 +/- 2 mg/dL), and 32 patients (5.9%) had a blood glucose level > or =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 < .001) and had a longer length of ICU stay (P < .001), but admission hyperglycemia was not associated with longer hospital stay or higher hospital mortality.


CONCLUSIONS
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.
Department of Medicine, Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA.
Andres
A
Palacio
Dawn
D
Smiley
Miguel
M
Ceron
Robin
R
Klein
Irene S
IS
Cho
Roberto
R
Mejia
Guillermo E
GE
Umpierrez
D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006764:Hospitals, Community; D006776:Hospitals, Pediatric; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D015278:Intensive Care Units, Pediatric; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome
D001786:Blood Glucose