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Association between Stress Hyperglycemia and Adverse Outcomes in Children Visiting the Pediatric Emergency Department

Woori Bae1, Moon Bae Ahn2

  • 1Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

Children (Basel, Switzerland)
|April 23, 2022
PubMed

Insights

Stress hyperglycemia (SH) is common in children visiting the pediatric emergency department (PED). Elevated blood glucose levels in these children are linked to increased hospital admissions and mortality rates.

Area of Science:

  • Pediatric Emergency Medicine
  • Endocrinology
  • Clinical Research

Background:

  • Stress hyperglycemia (SH) is recognized in pediatric emergency departments (PEDs).
  • In adults, SH is linked to adverse health outcomes, including mortality.
  • The impact of SH on adverse outcomes in children requires further investigation.

Purpose of the Study:

  • To determine adverse outcomes associated with blood glucose (BG) levels in children presenting to a pediatric emergency department.
  • To analyze the incidence and implications of SH in pediatric patients.

Main Methods:

  • Retrospective analysis of electronic medical records for children under 18 years old.
  • Data collected from January 1, 2011, to December 31, 2020, from tertiary hospitals.
  • Inclusion of 44,905 patient visits, with SH identified in 1506 (3.4%).

Main Results:

  • Patients with SH exhibited significantly higher rates of ward admission (52.6% vs. 35.9%), ICU admission (2.6% vs. 0.7%), and mortality (2.7% vs. 0.3%) compared to normoglycemic patients.
  • Elevated BG levels showed a dose-dependent increase in mortality risk.
  • Odds ratios for mortality increased substantially with BG levels of 150 mg/dL and above.

Conclusions:

  • Stress hyperglycemia is a prevalent condition in children visiting the PED.
  • SH in children is significantly associated with increased adverse outcomes, including higher mortality.
  • Prompt identification of SH causes and timely intervention are crucial for improving pediatric patient outcomes.

Keywords:
childemergency departmentmortalitystress hyperglycemia

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