Volume 11, Issue 1 (2025)
CJP 2025, 11(1): e20 |
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Dar M I, Parihar R K, Bhat V. Association of Stress Hyperglycemia with Mortality and Clinical Outcomes in Critically Ill children: A Cross-Sectional Study. CJP 2025; 11 (1)
URL: http://caspianjp.ir/article-1-272-en.html
URL: http://caspianjp.ir/article-1-272-en.html
Department of Pediatrics, Government Medical College Jammu, India , darirfan53@gmail.com
Abstract: (20 Views)
Background and Objective: Hyperglycemia is a recognized response to acute stress in critically ill patients, arising from complex hormonal, inflammatory, and metabolic changes. Stress hyperglycemia (SH) frequently occurs in pediatric intensive care and is associated with increased morbidity and mortality. This study aimed to evaluate the association between SH and clinical outcomes in critically ill pediatric patients.
Methods: A cross-sectional study was conducted over one year in the Pediatric Intensive Care Unit (PICU) of the Government Medical College Jammu. Non-diabetic, critically ill children aged 1 month to 17 years requiring PICU care for at least 24 hours were included. Blood glucose levels were measured at admission and every 12 hours, with SH defined as blood glucose >140 mg/dL. Statistical analyses included t-tests, Chi-Square tests, ROC curve analysis, and multivariate logistic regression.
Findings: Of 204 children, 129 (63.24%) were hyperglycemic, with a median onset on the first day and a median duration of 2 days. Hyperglycemic patients had significantly higher median glucose levels at admission (141 mg/dL vs. 95 mg/dL) and peak glucose levels (211 mg/dL vs. 122 mg/dL) compared to non-hyperglycemic patients (P<0.0001). SH was associated with higher mortality (54.26% vs. 22.67%, P<0.0001), longer ventilator use (72.87% vs. 40%), and increased vasoactive support (76.74% vs. 41.33%). Peak glucose >177 mg/dL moderately predicted mortality (AUC 0.701).
Conclusion: SH is a significant marker of severity in critically ill pediatric patients, correlating with increased mortality and longer PICU stays. Future studies are needed to refine glycemic control strategies.
Methods: A cross-sectional study was conducted over one year in the Pediatric Intensive Care Unit (PICU) of the Government Medical College Jammu. Non-diabetic, critically ill children aged 1 month to 17 years requiring PICU care for at least 24 hours were included. Blood glucose levels were measured at admission and every 12 hours, with SH defined as blood glucose >140 mg/dL. Statistical analyses included t-tests, Chi-Square tests, ROC curve analysis, and multivariate logistic regression.
Findings: Of 204 children, 129 (63.24%) were hyperglycemic, with a median onset on the first day and a median duration of 2 days. Hyperglycemic patients had significantly higher median glucose levels at admission (141 mg/dL vs. 95 mg/dL) and peak glucose levels (211 mg/dL vs. 122 mg/dL) compared to non-hyperglycemic patients (P<0.0001). SH was associated with higher mortality (54.26% vs. 22.67%, P<0.0001), longer ventilator use (72.87% vs. 40%), and increased vasoactive support (76.74% vs. 41.33%). Peak glucose >177 mg/dL moderately predicted mortality (AUC 0.701).
Conclusion: SH is a significant marker of severity in critically ill pediatric patients, correlating with increased mortality and longer PICU stays. Future studies are needed to refine glycemic control strategies.
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