Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients

Marc G. Jeschke, Ruxandra Pinto, David Herndon, Celeste Finnerty, Robert Kraft

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: The objective of this study was to determine the prevalence of hypoglycemia after burn injury and whether hypoglycemia is associated with increased postburn morbidity and mortality. Design: Cohort analysis. Setting: Academic pediatric burn hospital. Patients: This analysis included 760 pediatric burn patients, who were stratified according the number of hypoglycemic episodes (< 60 mg/dL glucose) they experienced while in the ICU. Clinical outcomes and metabolic and inflammatory biomarkers were analyzed during the first 60 days post admission. Patients with one or more hypoglycemic events were matched with patients not experiencing any event using propensity score matching, and outcomes and biomarker expression were compared between groups. Measurements and Main Results: Eighty-four patients had one episode of hypoglycemia, 108 patients had two or more episodes of hypoglycemia, and 568 patients never experienced hypoglycemia. Patients with one or more hypoglycemic episodes had longer hospitalization, as well as more frequent infections, sepsis, multiple organ failure, and death (p < 0.05). The 166 propensity score-matched patients with one or more hypoglycemic events had greater inflammatory and metabolic responses, prevalence of sepsis, multiple organ failure, and mortality than burn patients without hypoglycemic (p < 0.05). Conclusions: Hypoglycemic episodes correlate with injury severity and inhalation injury. When adjusted for injury severity, hypoglycemia is associated with significantly higher postburn morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)1221-1231
Number of pages11
JournalCritical Care Medicine
Volume42
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Hypoglycemia
Pediatrics
Morbidity
Hypoglycemic Agents
Mortality
Propensity Score
Multiple Organ Failure
Wounds and Injuries
Sepsis
Biomarkers
Pediatric Hospitals
Inhalation
Hospitalization
Cohort Studies
Glucose
Infection

Keywords

  • burn size
  • critical care
  • hypoglycemia
  • inflammation
  • insulin
  • morbidity
  • pediatric

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients. / Jeschke, Marc G.; Pinto, Ruxandra; Herndon, David; Finnerty, Celeste; Kraft, Robert.

In: Critical Care Medicine, Vol. 42, No. 5, 2014, p. 1221-1231.

Research output: Contribution to journalArticle

Jeschke, Marc G. ; Pinto, Ruxandra ; Herndon, David ; Finnerty, Celeste ; Kraft, Robert. / Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients. In: Critical Care Medicine. 2014 ; Vol. 42, No. 5. pp. 1221-1231.
@article{e362a35319b44dee893a830fcb979c40,
title = "Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients",
abstract = "Objective: The objective of this study was to determine the prevalence of hypoglycemia after burn injury and whether hypoglycemia is associated with increased postburn morbidity and mortality. Design: Cohort analysis. Setting: Academic pediatric burn hospital. Patients: This analysis included 760 pediatric burn patients, who were stratified according the number of hypoglycemic episodes (< 60 mg/dL glucose) they experienced while in the ICU. Clinical outcomes and metabolic and inflammatory biomarkers were analyzed during the first 60 days post admission. Patients with one or more hypoglycemic events were matched with patients not experiencing any event using propensity score matching, and outcomes and biomarker expression were compared between groups. Measurements and Main Results: Eighty-four patients had one episode of hypoglycemia, 108 patients had two or more episodes of hypoglycemia, and 568 patients never experienced hypoglycemia. Patients with one or more hypoglycemic episodes had longer hospitalization, as well as more frequent infections, sepsis, multiple organ failure, and death (p < 0.05). The 166 propensity score-matched patients with one or more hypoglycemic events had greater inflammatory and metabolic responses, prevalence of sepsis, multiple organ failure, and mortality than burn patients without hypoglycemic (p < 0.05). Conclusions: Hypoglycemic episodes correlate with injury severity and inhalation injury. When adjusted for injury severity, hypoglycemia is associated with significantly higher postburn morbidity and mortality.",
keywords = "burn size, critical care, hypoglycemia, inflammation, insulin, morbidity, pediatric",
author = "Jeschke, {Marc G.} and Ruxandra Pinto and David Herndon and Celeste Finnerty and Robert Kraft",
year = "2014",
doi = "10.1097/CCM.0000000000000138",
language = "English (US)",
volume = "42",
pages = "1221--1231",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Hypoglycemia is associated with increased postburn morbidity and mortality in pediatric patients

AU - Jeschke, Marc G.

AU - Pinto, Ruxandra

AU - Herndon, David

AU - Finnerty, Celeste

AU - Kraft, Robert

PY - 2014

Y1 - 2014

N2 - Objective: The objective of this study was to determine the prevalence of hypoglycemia after burn injury and whether hypoglycemia is associated with increased postburn morbidity and mortality. Design: Cohort analysis. Setting: Academic pediatric burn hospital. Patients: This analysis included 760 pediatric burn patients, who were stratified according the number of hypoglycemic episodes (< 60 mg/dL glucose) they experienced while in the ICU. Clinical outcomes and metabolic and inflammatory biomarkers were analyzed during the first 60 days post admission. Patients with one or more hypoglycemic events were matched with patients not experiencing any event using propensity score matching, and outcomes and biomarker expression were compared between groups. Measurements and Main Results: Eighty-four patients had one episode of hypoglycemia, 108 patients had two or more episodes of hypoglycemia, and 568 patients never experienced hypoglycemia. Patients with one or more hypoglycemic episodes had longer hospitalization, as well as more frequent infections, sepsis, multiple organ failure, and death (p < 0.05). The 166 propensity score-matched patients with one or more hypoglycemic events had greater inflammatory and metabolic responses, prevalence of sepsis, multiple organ failure, and mortality than burn patients without hypoglycemic (p < 0.05). Conclusions: Hypoglycemic episodes correlate with injury severity and inhalation injury. When adjusted for injury severity, hypoglycemia is associated with significantly higher postburn morbidity and mortality.

AB - Objective: The objective of this study was to determine the prevalence of hypoglycemia after burn injury and whether hypoglycemia is associated with increased postburn morbidity and mortality. Design: Cohort analysis. Setting: Academic pediatric burn hospital. Patients: This analysis included 760 pediatric burn patients, who were stratified according the number of hypoglycemic episodes (< 60 mg/dL glucose) they experienced while in the ICU. Clinical outcomes and metabolic and inflammatory biomarkers were analyzed during the first 60 days post admission. Patients with one or more hypoglycemic events were matched with patients not experiencing any event using propensity score matching, and outcomes and biomarker expression were compared between groups. Measurements and Main Results: Eighty-four patients had one episode of hypoglycemia, 108 patients had two or more episodes of hypoglycemia, and 568 patients never experienced hypoglycemia. Patients with one or more hypoglycemic episodes had longer hospitalization, as well as more frequent infections, sepsis, multiple organ failure, and death (p < 0.05). The 166 propensity score-matched patients with one or more hypoglycemic events had greater inflammatory and metabolic responses, prevalence of sepsis, multiple organ failure, and mortality than burn patients without hypoglycemic (p < 0.05). Conclusions: Hypoglycemic episodes correlate with injury severity and inhalation injury. When adjusted for injury severity, hypoglycemia is associated with significantly higher postburn morbidity and mortality.

KW - burn size

KW - critical care

KW - hypoglycemia

KW - inflammation

KW - insulin

KW - morbidity

KW - pediatric

UR - http://www.scopus.com/inward/record.url?scp=84899487551&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899487551&partnerID=8YFLogxK

U2 - 10.1097/CCM.0000000000000138

DO - 10.1097/CCM.0000000000000138

M3 - Article

C2 - 24368343

AN - SCOPUS:84899487551

VL - 42

SP - 1221

EP - 1231

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 5

ER -