Prognostic Factors of Concomitant Hyperglycemia and Hypocalcemia in Pediatric Intensive Care Units

Background: Hyperglycemia and hypocalcemia have separately been attributed to adverse outcomes in critically ill patients. This study aimed to investigate the simultaneous effects of the two conditions on mortality and morbidity in a pediatric intensive care unit. Methods: All children aged 1 month to 18 years, admitted for at least 24 hours to medical pediatric intensive care unit (PICU), Nemazee Hospital, Shiraz, Iran were reviewed over one year period. Those with a history of diabetes mellitus and any calcium disorders were excluded. Results: Data on blood glucose and calcium during the first 6 hours of admission, in-PICU length of stay, need for mechanical ventilation, vassopressor drugs administration, and mortality were assessed. The incidence of hyperglycemia [≥150 mg/dl (8.3mmol/L)] and hypocalcemia [serum calcium < 8.5 mg/dl (2.12mmol/L)] were 26.5% and 43.9%, respectively. Hyperglycemia and hypocalcemia were associated with increased mortality. Among the survivors, hyperglycemia and hypocalcemia had no significant effect on PICU length of stay. The interaction of hyperglycemia and hypocalcemia did not intensify their separate effects on mortality, the need for mechanical ventilation and vasopressor infusion. Conclusions: Although hyperglycemia and hypocalcemia separately increase the mortality rate, their simultaneous presence is not associated with poorer outcomes in critically ill patients.