Bae Woori, Ahn Moon Bae
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Children (Basel). 2022 Apr 2;9(4):505. doi: 10.3390/children9040505.
Stress hyperglycemia (SH) is often identified in patients visiting the pediatric emergency department (PED), and SH in adults has been associated with adverse outcomes, including mortality. In this retrospective study, we determined the adverse outcomes according to blood glucose (BG) levels of children visiting the PED of tertiary hospitals. Data were collected from the electronic medical records of children aged <18 years between 1 January 2011 and 31 December 2020. A total of 44,905 visits were included in the analysis. SH was identified in 1506 patients, with an incidence rate of 3.4%. Compared to those without SH, patients with SH had significantly higher ward admission rates (52.6% vs. 35.9%, p < 0.001), intensive care unit admission rates (2.6% vs. 0.7%, p < 0.001), and mortality rates (2.7% vs. 0.3%, p < 0.001). Compared to the normoglycemic group of 45 ≤ BG < 150 mg/dL, the odds ratios (95% CI) for mortality were 5.61 (3.35−9.37), 27.96 (14.95−52.26), 44.22 (17.03−114.82), and 39.94 (16.31−97.81) for levels 150 ≤ BG < 200, 200 ≤ BG < 250, 250 ≤ BG < 300 and ≥300 mg/dL, respectively. This suggests that SH is common in children visiting the PED and is associated with higher adverse outcomes. Thus, there is a need to quickly identify its cause and take prompt intervention to resolve it.
应激性高血糖（SH）在前往儿科急诊科（PED）就诊的患者中经常被发现，并且成人中的SH与包括死亡率在内的不良结局相关。在这项回顾性研究中，我们根据三级医院儿科急诊科就诊儿童的血糖（BG）水平确定了不良结局。数据收集自2011年1月1日至2020年12月31日期间年龄<18岁儿童的电子病历。分析共纳入44905次就诊。1506例患者被诊断为SH，发病率为3.4%。与无SH的患者相比，SH患者的病房住院率（52.6%对35.9%，p<0.001）、重症监护病房住院率（2.6%对0.7%，p<0.001）和死亡率（2.7%对0.3%，p<0.001）显著更高。与血糖正常组（45≤BG<150mg/dL）相比，BG水平为150≤BG<200、200≤BG<250、250≤BG<300和≥300mg/dL时的死亡率比值比（95%CI）分别为5.61（3.35−9.37）、27.96（14.95−52.26）、44.22（17.03−114.82）和39.94（16.31−97.81）。这表明SH在前往儿科急诊科就诊的儿童中很常见，并与更高的不良结局相关。因此，有必要迅速查明其原因并采取及时干预措施来解决它。
