| Early stress hyperglycemia as independent predictor of increased mortality in
preterm infants |
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Young Sun Wee, Gae Hyun Ahn, Eun Gyong Yoo, In Sook Lim, Kyu Hyung Lee |
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Department of Pediatrics, College of Medicine, Pochon CHA University, Sungnam, Korea |
| 미숙아에서 초기 스트레스성 고혈당과 예후 사이의 연관성 |
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위영선, 안계현, 유은경, 임인숙, 이규형 |
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포천중문의과대학교 소아과학교실 |
Correspondence:
Kyu Hyung Lee, Email: khlee45@yahoo.co.kr
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| Abstract |
Purpose
: Stress hyperglycemia is common in critically ill adult patients. It is known as a predictor of increased mortality, and intensive insulin therapy has been shown to improve the prognosis in such patients. We have investigated the relationship between early stress hyperglycemia and clinical outcomes in preterm infants.
Methods
: In this study, 141 preterm infants with a gestational age of less than 30 weeks were enrolled. The hyperglycemic group was defined as that having maximum glucose of more than 150 mg/dL (n=61) during the first 48 h of life, and the non-hyperglycemic group was defined as that having maximum glucose of less than 150 mg/dL (n=80). Perinatal history, severity of illness using the Clinical Risk Index for Babies (CRIB) score, clinical outcomes, and mortality of the two groups were compared.
Results
: There was no significant difference in the gestational age between the two groups, but the birth weight (P<0.001) was significantly lower, and the CRIB score (P<0.001) was significantly higher in the hyperglycemic group. Disseminated intravascular coagulation (P<0.001) and clinically suspected sepsis (P=0.046) were more common in the hyperglycemic group. Mortality was markedly higher in the hyperglycemic group (11.3% vs. 41.0%, P<0.001). On performing a stepwise multiple logistic regression analysis, hyperglycemia (OR 3.787; 95% CI 1.324 to 10.829), the CRIB score (OR 1.252; 95% CI 1.047 to 1.496) and birth weight (OR 0.997; 95% CI 0.994 to 1.000) was independently associated with higher mortality.
Conclusion
: Stress hyperglycemia within the first 48 h of life is independently related to increased morbidity and mortality in preterm infants. |
| Key Words:
Hyperglycemia, Preterm, Mortality, CRIB |
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