Korean Journal of Pediatrics 2010;53(3):323-328.
Published online March 15, 2010.
Effect of hyperglycemia on mortality rates in critically ill children
Seongkuk Kim1, Bo Eun Kim1, Eun Ju Ha1, Mi Young Moon2, Seong Jong Park1
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
소아 중환자에서 고혈당과 사망률과의 관계
김성국1, 김보은1, 하은주1, 문미영2, 박성종1
1울산대학교 의과대학 서울아산병원 소아청소년과
2울산대학교 의과대학 서울아산병원 약제팀
Correspondence: 
Seong Jong Park, Email: drpsj@amc.seoul.kr
Received: 11 March 2009   • Revised: 13 July 2009   • Accepted: 13 January 2010
Abstract
Purpose
: To verify the effect of hyperglycemia on mortality rates in critically ill children and to identify the blood glucose level that influences prognosis.
Methods
: From July 2006 to June 2008, a total of 206 patients who were admitted to the pediatric intensive care unit (PICU) at Asan Medical Center and who survived for more than 7 days were retrospectively reviewed. We analyzed the maximum glucose value within 7 days in PICU, PRISM-III score and SOFA score within 24 hours, and mortality. We did not perform an adjustment analysis of drugs affecting glucose level.
Results
: The maximum glucose level within 7 days in PICU was higher in the nonsurvival group than in the survival group. Using 4 cutoff values (125, 150, 175, and 200 mg/dL), the mortality of patients with hyperglycemia was found to be 13.0 %, 14.4%, 19.8%, and 21.1%, respectively, and the cutoff values of 175 and 200 mg/dL revealed significant differences in mortalities between the hyperglycemic and normoglycemic groups. The PRISM-III score was not significantly different between the hyperglycemic and normoglycemic groups under a glucose cutoff value of 175 mg/dL, but the SOFA score was higher in the hyperglycemic group. Under a glucose cutoff value of 200 mg/dL, the PRISM-III score was higher in the hyperglycemic group, and the SOFA score did not differ between the 2 groups.
Conclusion
: Hyperglycemia with a maximal glucose value ≥175 mg/dL during the first 7 days after PICU admission was associated with increased mortality in critically ill children.
Key Words: Hyperglycemia, Glucose, Children, Pediatrics, Pediatric intensive care, Mortality, Survival


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