Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu.
| Title: | Relationship between Glycemic Levels and Treatment Outcome among Critically Ill Children admitted into Emergency Room in Enugu. |
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| Authors: | Uleanya ND; Department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria. nulesa2001@yahoo.com.; Aniwada EC; Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.; Nwokoye IC; Department of Pediatrics, Federal Teaching Hospital, Abakaliki, Nigeria.; Ndu IK; Department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria.; Eke CB; Department of Pediatric, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria. |
| Source: | BMC pediatrics [BMC Pediatr] 2017 May 16; Vol. 17 (1), pp. 126. Date of Electronic Publication: 2017 May 16. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100967804 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2431 (Electronic) Linking ISSN: 14712431 NLM ISO Abbreviation: BMC Pediatr Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| MeSH Terms: | Emergency Service, Hospital*; Critical Illness/*therapy ; Hyperglycemia/*complications ; Hypoglycemia/*complications; Critical Illness/mortality ; Hyperglycemia/diagnosis ; Hypoglycemia/diagnosis ; Length of Stay/statistics & numerical data ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Logistic Models ; Male ; Nigeria ; Prognosis ; Risk Factors ; Survival Rate ; Treatment Outcome |
| Abstract: | Background: Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay.; Methods: Analytical cross sectional method was used to study critically ill children aged ≥1 month to ≤10 years admitted into the Children Emergency Room of Enugu State University Teaching Hospital, Enugu. Their admission blood glucose was done. Interviewer administered questionnaire was used to collect information including sociodemographics, duration of hospitalization and outcome of treatment. Data was analysed using SPSS version 20. Chi square, logistic regressions and Kruskal Wallis tests were done as appropriate.; Results: A total of 300 patients were recruited. One hundred and seventeen (39%) had hyperglycemia, 62 (20.7%) patients had hypoglycaemia and 121 (40.3%) had euglycemia. Two hundred and fifty two (84%) were discharged while 48 (16%) died. There was significant association between glycemic levels and treatment outcome (p = < 0.001). Among the 48 who died, 12 (25.0%) had euglycemia, 21 (43.75%) had hypoglycaemia while 15 (31.25%) had hyperglycemia. On multivariate analysis, there was statistically significant association between hypoglycaemia and mortality (p = < 0.001). Unadjusted, those children with hypoglycaemia at presentation were about 4.7 times (UOR = 0.21, 95% Cl: 0.08-0.38) and adjusted, about 5 times (AOR = 0.20, 95% CI: 0.09-0.47) less likely to survive compared with those with euglycemia. Although not statistically significant, those with hyperglycemia were about 1.3 times less likely to survive compared with euglycemic children, adjusted and unadjusted (UOR = 0.75, 95% Cl: 0.33-1.68).; Conclusion: While both hypo- and hyperglycemia are associated with mortality, hypoglycaemia had a greater effect than hyperglycemia. Glycemic levels significantly affects treatment outcome. |
| References: | J Trop Pediatr. 2006 Apr;52(2):96-102. (PMID: 16169861); Pediatr Crit Care Med. 2008 Jul;9(4):361-6. (PMID: 18496414); Diabetes. 2003 Nov;52(11):2795-804. (PMID: 14578299); Pediatr Crit Care Med. 2004 Jul;5(4):329-36. (PMID: 15215001); Crit Care. 2013 Mar 06;17(2):305. (PMID: 23470218); Am J Obstet Gynecol. 2009 May;200(5):e45-51. (PMID: 19168170); Nature. 2001 Dec 13;414(6865):813-20. (PMID: 11742414); J Diabetes Sci Technol. 2012 Jan 01;6(1):37-47. (PMID: 22401321); Pediatrics. 2006 Jul;118(1):173-9. (PMID: 16818563); Med J Islam Repub Iran. 2012 May;26(2):78-84. (PMID: 23482397); World J Crit Care Med. 2012 Feb 04;1(1):31-9. (PMID: 24701399); Indian J Crit Care Med. 2014 Jan;18(1):8-13. (PMID: 24550607); JAMA. 2003 Oct 15;290(15):2041-7. (PMID: 14559958); BMC Infect Dis. 2010 Nov 22;10:334. (PMID: 21092224); Lancet. 2000 Mar 4;355(9206):773-8. (PMID: 10711923); Indian Pediatr. 2011 Jul;48(7):531-6. (PMID: 21813922); N Engl J Med. 2009 Jan 8;360(2):111-20. (PMID: 19129525); Diabetes. 1989 Aug;38(8):1031-5. (PMID: 2753233); Anesth Analg. 1999 May;88(5):1011-6. (PMID: 10320160); Pediatr Endocrinol Diabetes Metab. 2007;13(1):43-6. (PMID: 17493406); J Diabetes Sci Technol. 2012 Jan 01;6(1):48-57. (PMID: 22401322); Am J Med. 1982 Mar;72(3):439-50. (PMID: 7036735); Intensive Care Med. 2003 Apr;29(4):642-5. (PMID: 12552364); Pediatr Crit Care Med. 2010 Nov;11(6):690-8. (PMID: 20625333); Anesthesiology. 2010 Mar;112(3):576-85. (PMID: 20124983); J Clin Invest. 2004 Nov;114(9):1187-95. (PMID: 15520847); Diabetologia. 1994 Aug;37(8):797-807. (PMID: 7988782); Chest. 2008 Jun;133(6):1328-35. (PMID: 18339779) |
| Contributed Indexing: | Keywords: Children; Critically ill; Hyperglycemia; Hypoglycemia; Treatment outcome |
| Entry Date(s): | Date Created: 20170518 Date Completed: 20180223 Latest Revision: 20260127 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC5434620 |
| DOI: | 10.1186/s12887-017-0879-8 |
| PMID: | 28511644 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't