Alaei Fariba, Davari Paridokht Nakhostin, Alaei Mastaneh, Azarfarin Rasoul, Soleymani Ebrahim
Department of Pediatric Cardiology, Rajaei Heart Center, Tehran, Iran.
Pediatr Cardiol. 2012 Jan;33(1):21-6. doi: 10.1007/s00246-011-0060-3. Epub 2011 Aug 18.
This prospective cohort study aimed to determine the morbidity and mortality among hyperglycemic pediatric patients after cardiac surgery. The study was conducted in a pediatric intensive care unit (PICU) for cardiac surgery patients at a university-affiliated, referral, heart hospital. A total of 379 postcardiac surgery pediatric patients participated in the study. No interventions were performed. Measurements of blood glucose level together with other clinical and laboratory data were collected on postoperative days 1, 2, 3, and 7. Mean blood glucose level exceeding 126 mg/dl was considered hyperglycemia, and a level exceeding 200 mg/dl determined severe hyperglycemia. These measurements were analyzed for association with major complications and death. Hyperglycemia was common (86%) in this cohort study. There was no statistical correlation between hyperglycemia and death or major complications, but patients with severe hyperglycemia showed a significantly higher mortality rate (16/64 deaths [25%] vs. 13/315 deaths [4.12%]; P < 0.001]) and more morbidities (16/64 [25%] vs. 43/315 [13.65%]; P = 0.022). Severe hyperglycemia was independently associated with mortality according to multivariate logistic regression. Hyperglycemia is quite prevalent among pediatric patients after cardiac surgeries. Severe hyperglycemia is associated with higher morbidity and mortality rates in this patient population.
这项前瞻性队列研究旨在确定心脏手术后高血糖儿科患者的发病率和死亡率。该研究在一所大学附属医院、转诊心脏医院的心脏手术患儿重症监护病房（PICU）进行。共有379名心脏手术后的儿科患者参与了该研究。未进行干预。在术后第1、2、3和7天收集血糖水平测量值以及其他临床和实验室数据。平均血糖水平超过126mg/dl被视为高血糖，超过200mg/dl则确定为严重高血糖。对这些测量值进行分析，以确定其与主要并发症和死亡的关联。在这项队列研究中，高血糖很常见（86%）。高血糖与死亡或主要并发症之间无统计学相关性，但严重高血糖患者的死亡率显著更高（64例死亡中有16例[25%]，而315例死亡中有13例[4.12%]；P<0.001），且发病率更高（64例中有16例[25%]，而315例中有43例[13.65%]；P = 0.022）。根据多因素逻辑回归分析，严重高血糖与死亡率独立相关。高血糖在心脏手术后的儿科患者中相当普遍。在该患者群体中，严重高血糖与更高的发病率和死亡率相关。
