Background: Abnormal blood glucose in sick children is known to be common and carries a poor prognosis being associated with increased morbidity and mortality.
Aim: To compare the clinical outcome in children admitted to the PEU of KATH with normal and abnormal blood glucose (hypoglycaemia or hyperglycaemia).
Method: Prospective cohort study involving 430 children, 215 each with normal and abnormal blood glucose, selected from screening a total of 800 participants. They were matched for age group and diagnosis and clinical outcome compared. Participants were followed up till discharge. Complications, mortality and final diagnoses were recorded.
Results: Twenty seven percent (116/430) of patients had at least one complication on admission and 22% (96/430) had abnormal blood glucose (P=0.000). The commonest complications were shock, intravascular haemolysis and acute renal failure. At the end of the study, 89% (382/430) were discharged well, 9% (40/430) died and 2% (8/430) were discharged with complication(s). 75% (6/8) of those discharged with complication(s), and 75% (30/40) of those who died had abnormal blood glucose (P<0.001). Of those with abnormal blood glucose who died, 36% (10/28) had hypoglycaemia and 11% (20/187) had hyperglycaemia (P=0.000). The risk ratio of patients with abnormal blood glucose dying was three (95% CI: 1.56.0) (P<0.001). The risk ratio of developing a complication was 4.8 (95% CI: 3.17.5) (P=0.000).
Conclusion: Abnormal blood glucose was a common finding in children admitted to PEU, KATH, with acute medical conditions and was associated with increased complications including mortality. Hypoglycaemia on admission was a greater predictive factor of complications and mortality than hyperglycemia.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology