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

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

Research output: Contribution to journalArticle

21 Scopus citations

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 - May 2014

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Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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