Persistent hyperglycemia in critically ill children
Persistent hyperglycemia in critically ill children
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DOI：
10.1016/j.jpeds.2004.08.076
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发表时间：
2005-01-01
影响因子：
5.1
通讯作者：
Apkon, M
中科院分区：
文献类型：
--
作者：
Faustino, EV;Apkon, M
Objectives To determine the prevalence and prognostic significance of glucocorticoids among critically ill nondiabetic children.Study design我们进行了一项回顾性队列研究，使用即时血糖测量、医院管理数据库和计算机化信息系统; 942名非糖尿病患者从2000年10月至2003年9月入住我们的儿科重症监护室（PICU）。高血糖症的患病率基于最初的PICU血糖测量，24小时内的最高值，以及首次测量后10天内PICU住院期间测量的最高值。主要结果是院内死亡与PICU住院时间（LOS）作为次要outcome.Results通过使用三个临界值（120 mg/dL，150 mg/dL，200 mg/dL），高血糖症的患病率，是16.7%至75.0%。死亡的相对风险（RR）在24小时内最大血糖>150 mg/dL（RR. 2.50; 95%置信区间（CI），1.26至4.93）和10天内最高血糖>120 mg/dL（RR，5.68; 95% CI，1.38至23.47）。入院血糖>120 mg/dL和150 mg/dL时LOS降低，但10 day.Conclusions高血压在非糖尿病重症儿童中频繁发生，与更高的住院死亡率和更长的LOS相关。
Objectives To determine the prevalence and prognostic significance of hyperglycemia among critically ill nondiabetic children.Study design We performed a retrospective cohort study using point-of-care blood glucose measurements, hospital administrative databases, and a computerized information system; 942 nondiabetic patients admitted to our Pediatric Intensive Care Unit (PICU) from October 2000 to September 2003 were included. The prevalence of hyperglycemia was based on initial PICU glucose measurement, highest value within 24 hours, and highest value measured during PICU stay up to 10 days after the, first measurement. Primary outcome was in-hospital death with PICU lengths of stay (LOS) as secondary outcome.Results Through the use of three cutoff values (120 mg/dL, 150 mg/dL, and 200 mg/dL), the prevalence of hyperglycemia, was 16.7% to 75.0%. The relative risk (RR) for dying increased for maximum glucose within 24 hours >150 mg/dL (RR. 2.50; 95% confidence interval (CI), 1.26 to 4.93) and highest glucose within 10 days >120 mg/dL (RR, 5.68; 95% CI, 1.38 to 23.47). LOS was decreased for admission glucose >120 mg/dL and 150 mg/dL but increased for all threshold values for maximum glucose within 10 days.Conclusions Hyperglycemia occurs frequently among critically ill nondiabetic children and is correlated with a greater in-hospital mortality rate and longer LOS.