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

BACKGROUND: Inpatient 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.
METHODS: The 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.
RESULTS: A 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.
CONCLUSIONS: Hyperglycemia 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. (c) 2008 Society of Hospital Medicine