Blood glucose as a marker of venous thromboembolism in critically ill children. (June 2014)

• Record Type: Journal Article
• Authors: Tala, J. A.; Silva, C. T.; Pemira, S.; Vidal, E.; Faustino, E. V. S.
• Is Part Of: Journal of thrombosis and haemostasis. Volume 12:Number 6(2014:Jun.)
• Page Start: 891
• Page End: 896
• Publication Date: 2014-06
• Subjects: Thrombosis -- Periodicals; Hemostasis -- Periodicals; Blood coagulation disorders -- Periodicals; 616.1
• DOI: 10.1111/jth.12583
• Languages: English
• ISSNs: 1538-7933

Abstract

<abstract abstract-type="main" id="jth12583-abs-0001"> <title>Summary</title> <sec id="jth12583-sec-0001" sec-type="section"> <title>Background</title> <p>The ability to predict the development of venous thromboembolism is highly desirable.</p> </sec> <sec id="jth12583-sec-0002" sec-type="section"> <title>Objective</title> <p>We aim to determine the association between hyperglycemia and venous thromboembolism in non‐diabetic critically ill children.</p> </sec> <sec id="jth12583-sec-0003" sec-type="section"> <title>Patients/Methods</title> <p>We conducted a retrospective cohort study that included children in the pediatric intensive care unit on a vasopressor or mechanical ventilator and without history of diabetes mellitus or prior diagnosis of thrombosis. Based on maximum blood glucose > 150 mg dL<sup>−1</sup> while admitted to the unit, children were categorized as hyperglycemic or non‐hyperglycemic. The primary outcome was development of venous thromboembolism while admitted to the unit. We determined the association between hyperglycemia and venous thromboembolism using logistic regression models adjusting for selected subject characteristics.</p> </sec> <sec id="jth12583-sec-0004" sec-type="section"> <title>Results</title> <p>Of the 789 subjects analyzed, 34 subjects developed venous thromboembolism (incidence, 4.3%; 95% confidence interval, 3–6%). Venous thromboembolism was more likely to develop in hyperglycemic subjects compared with non‐hyperglycemic subjects. A total of 31 subjects (6.2%; 95% confidence interval, 4.2–8.7%) developed venous thromboembolism after becoming hyperglycemic compared with three non‐hyperglycemic subjects with venous thromboembolism (1%; 95% confidence interval, 0.2–3%). When adjusted for age, diagnosis, presence of central venous catheter, prophylactic antithrombotic use and severity of illness, the odds ratio of venous thromboembolism with hyperglycemia was 4.1 (95% confidence interval, 1.2–14.1). For every 10 mg dL<sup>−1</sup> increase in maximum blood glucose, the adjusted odds ratio of venous thromboembolism was 1.04 (95% confidence interval, 1.01–1.06).</p> </sec> <sec id="jth12583-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Hyperglycemia is associated with venous thromboembolism in critically ill non‐diabetic children. Maximum blood glucose is a potential predictor of venous thromboembolism in this population.</p> </sec> </abstract>