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. 2013 Aug;89(2):232-237.
doi: 10.4269/ajtmh.13-0016. Epub 2013 Jul 1.

Blood glucose as a predictor of mortality in children admitted to the hospital with febrile illness in Tanzania

Behzad Nadjm, George Mtove, Ben Amos, Helena Hildenwall, Anne Najjuka, Frank Mtei, Jim Todd, Hugh Reyburn

Blood glucose as a predictor of mortality in children admitted to the hospital with febrile illness in Tanzania

Behzad Nadjm et al. Am J Trop Med Hyg. 2013 Aug.

Abstract

Data from a prospective study of 3,319 children ages 2 months to 5 years admitted with febrile illness to a Tanzanian district hospital were analyzed to determine the relationship of blood glucose and mortality. Hypoglycemia (blood sugar < 2.5 mmol/L and < 45 mg/dL) was found in 105 of 3,319 (3.2%) children at admission, and low-normal blood glucose (2.5-5 mmol/L and 45-90 mg/dL) was found in 773 of 3,319 (23.3%) children. Mortality was inversely related to admission blood sugar; compared with children with an admission blood glucose of > 5 mmol/L, the adjusted odds of dying were 3.3 (95% confidence interval = 2.1-5.2) and 9.8 (95% confidence interval = 5.1-19.0) among children with admission blood glucose 2.5-5 and < 2.5 mmol/L, respectively. Receiver operating characteristic (ROC) analysis suggested an optimal cutoff for admission blood sugar of < 5 mmol/L in predicting mortality (sensitivity = 57.7%, specificity = 75.2%). A cutoff for admission blood glucose of < 5 mmol/L represents a simple and clinically useful predictor of mortality in children admitted with severe febrile illness to hospital in resource-poor settings.

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Figures

Figure 1.
Figure 1.
Risk of death by admission blood glucose according to the presence of asexual parasites of P. falciparum in the admission blood slide. Risk of death overall was 4.4% for slide-positive and 6.2% for slide-negative children. Bars represent 95% CIs.
Figure 2.
Figure 2.
ROC curves for blood glucose as a predictor of mortality in children admitted to the hospital. (A) Univariate association. (B) Blood glucose as one factor in a logistic regression model including age, blood lactate, presence of severe anemia, deep breathing, altered consciousness, severe malnutrition, hypoxia, malaria infection, presence of invasive bacterial disease, and coma.
See this image and copyright information in PMC

References

    1. Sperling MA. Hypoglycemia. In: Nelson WE, editor. Nelson Textbook of Paediatrics. Philadelphia, PA: WB Saunders Company; 1996.
    1. Marsh K, Forster D, Waruiru C, Mwangi I, Winstanley M, Marsh V, Newton C, Winstanley P, Warn P, Peshu N, Pasvol G, Snow R. Indicators of life-threatening malaria in African children. N Engl J Med. 1995;332:1399–1404. - PubMed
    1. White NJ, Miller KD, Marsh K, Berry CD, Turner RC, Williamson DH, Brown J. Hypoglycaemia in African children with severe malaria. Lancet. 1987;1:708–711. - PubMed
    1. Ssekitoleko R, Jacob ST, Banura P, Pinkerton R, Meya DB, Reynolds SJ, Kenya-Mugisha N, Mayanja-Kizza H, Muhindo R, Bhagani S, Scheld WM, Moore CC. Hypoglycemia at admission is associated with inhospital mortality in Ugandan patients with severe sepsis. Crit Care Med. 2011;39:2271–2276. - PMC - PubMed
    1. Osier FH, Berkley JA, Ross A, Sanderson F, Mohammed S, Newton CR. Abnormal blood glucose concentrations on admission to a rural Kenyan district hospital: prevalence and outcome. Arch Dis Child. 2003;88:621–625. - PMC - PubMed

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