Ameyaw Emmanuel, Amponsah-Achiano Kwame, Yamoah Peter, Chanoine Jean-Pierre
Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana.
Disease Control Unit, Ghana Health Service, Accra, Ghana.
Int J Pediatr. 2014;2014:149070. doi: 10.1155/2014/149070. Epub 2014 Dec 28.
Dysglycaemia (hyper- or hypoglycaemia) in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU) at Komfo Anokye Teaching Hospital (KATH) for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia) were enrolled. The median age was 24 months (range: 3-144 months). In the dysglycaemia group, 28 (13%) subjects had hypoglycemia and 187 (87%) had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n = 99, 46%) compared to euglycaemia group (n = 17, 8%) (P < 0.001). Forty subjects died out of whom 30 had dysglycaemia (P = 0.001). Subjects with dysglycaemia were 3 times (95% CI: 1.5-6.0) more likely to die and 4.8 times (95% CI: 3.1-7.5) more likely to develop complications (P = 0.001). Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition.
危重症儿童的血糖异常(高血糖或低血糖)与不良预后相关。我们比较了因急性疾病入住科姆福·阿诺克耶教学医院(KATH)儿科急诊科(PEU)且血糖正常或异常的儿童的临床结局。这是一项前瞻性病例匹配队列研究。从800名年龄在3至144个月之间的受试者中进行筛选,其中430名(215名血糖正常,215名血糖异常)被纳入研究。中位年龄为24个月(范围:3至144个月)。在血糖异常组中,28名(13%)受试者为低血糖,187名(87%)为高血糖。总体而言,116名受试者出现了128例并发症。血糖异常组出现并发症的受试者数量(n = 99,46%)显著高于血糖正常组(n = 17,8%)(P < 0.001)。40名受试者死亡,其中30名患有血糖异常(P = 0.001)。血糖异常的受试者死亡可能性高3倍(95%可信区间:1.5 - 6.0),发生并发症的可能性高4.8倍(95%可信区间:3.1 - 7.5)(P = 0.001)。血糖异常与患有急性疾病的儿童发病率和死亡率增加相关,应导致对潜在疾病进行强化管理。