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Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients

Marc G Jeschke1, Ruxandra Pinto, David N Herndon

  • 11Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. 2Division of Plastic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. 3Department of Immunology, University of Toronto, Toronto, ON, Canada. 4TECC Program Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. 5Shriners Hospitals for Children and University of Texas Medical Branch, Galveston, TX. 6Department of Surgery, University of Texas Medical Branch, Galveston, TX. 7Sealy Center for Molecular Medicine and the Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX.

Critical Care Medicine
|December 26, 2013
PubMed

Insights

Hypoglycemia after burn injury is common and linked to worse outcomes. This study found that even one hypoglycemic episode increases infection, organ failure, and death risk in pediatric burn patients.

Area of Science:

  • Pediatric critical care medicine
  • Burn research
  • Metabolic disorders

Background:

  • Hypoglycemia, defined as blood glucose < 60 mg/dL, is a critical concern in burn patients.
  • Understanding the prevalence and impact of hypoglycemia is vital for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence of hypoglycemia in pediatric burn patients.
  • To investigate the association between hypoglycemia and postburn morbidity and mortality.

Main Methods:

  • A cohort analysis of 760 pediatric burn patients admitted to an academic burn hospital.
  • Patients were stratified by the number of hypoglycemic episodes in the ICU.
  • Propensity score matching was used to compare outcomes between patients with and without hypoglycemia.

Main Results:

  • 84 patients experienced one hypoglycemic episode, and 108 had two or more.
  • Patients with hypoglycemia showed longer hospital stays, increased infections, sepsis, multiple organ failure, and mortality.
  • Matched analysis confirmed greater inflammatory and metabolic responses, sepsis, organ failure, and mortality in hypoglycemic patients.

Conclusions:

  • Hypoglycemia correlates with burn injury severity and inhalation injury.
  • After adjusting for injury severity, hypoglycemia remains a significant predictor of increased postburn morbidity and mortality.
Abstract

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