Prevalence and clinical outcome of inpatient hyperglycemia in a community pediatric hospital.

backgroundInpatient hyperglycemia in adult patients with and without a history of diabetes is a predictor of poor clinical outcome. No previous studies, however, have examined the association of hyperglycemia and clinical outcome in children admitted to a community pediatric hospital.

methodsThe study was a retrospective observational cohort of pediatric patients admitted to a community children's hospital from January 2004 to August 2004. Medical records of 903 consecutive children admitted to critical and non-critical care areas were reviewed. Of them, 342 patients (38%) had no blood glucose measurements during their hospital stay. In the remaining patients, we determined the prevalence of hyperglycemia and examined the association of hyperglycemia with clinical outcome.

resultsA total of 406 patients (75%) had an admission blood glucose < or =120 mg/dL (mean +/- SEM 98 +/- 1 mg/dL), 103 children (19%) had an admission blood glucose level of 121-179 mg/dL (mean 143 +/- 2 mg/dL), and 32 patients (5.9%) had a blood glucose level > or =180 mg/dL (mean 260 +/- 18 mg/dL). Seventeen patients (13%) had a known history of diabetes prior to admission. Children with hyperglycemia were more likely to be admitted to the ICU (P < .001) and had a longer length of ICU stay (P < .001), but admission hyperglycemia was not associated with longer hospital stay or higher hospital mortality.

conclusionsHyperglycemia is present in one-fourth of children admitted to the hospital, most of them without a history of diabetes prior to admission. Hyperglycemia was associated with a greater need for ICU care and longer ICU stay but not with increased in-hospital mortality.