Age <30 days was a strong independent predictor of intraoperative hypoglycemia compared to age ≥5 years (AOR 4.2; 95% CI 3.4-5.3), along with low weight, ASA ≥III, and abdominal surgery.
Cohort (n=26,142)
Yes
Young age, low weight for age, higher ASA status, and specific comorbidities are significant risk factors for intraoperative hypoglycemia in children, warranting targeted glucose monitoring.
Odds Ratio: 4.2 (95% CI 3.4–5.3)
BACKGROUND: Intraoperative hypoglycemia can result in devastating neurologic injury if not promptly diagnosed and treated. Few studies have defined risk factors for intraoperative hypoglycemia. The authors sought to characterize children with intraoperative hypoglycemia and determine independent risk factors in a multicenter cohort. METHODS: This retrospective multicenter study included all patients <18 years undergoing an anesthetic from January 1, 2012, to December 31, 2016, at 12 institutions participating in the Multicenter Perioperative Outcomes Group (MPOG). The primary outcome was blood glucose <60 mg/dL (3.3 mmol/L). Data collected included patient characteristics, comorbidities, and intraoperative factors. A multivariable logistic regression model was used to identify independent predictors of intraoperative hypoglycemia. RESULTS: Blood glucose was measured in 26,142 of 394,231 (6.6%) cases. Of these, 1017 (3.9%) had a glucose <60 mg/dL (3.3 mmol/L). Independent predictors for intraoperative hypoglycemia identified were age <30 days (estimated adjusted odds ratio AOR vs ≥5 years 4.2; 95% confidence interval CI, 3.4-5.3), age 30 days to <5 years (estimated AOR vs ≥5 years 2.7; 95% CI, 2.3-3.2), weight for age <5th percentile (estimated AOR, 1.6; 95% CI, 1.4-1.9), American Society of Anesthesiologists (ASA) status ≥III (estimated AOR, 1.3; 95% CI, 1.1-1.6), presence of a gastric or jejunal tube (estimated AOR, 1.3; 95% CI, 1.1-1.6), poor feeding (estimated AOR, 1.5; 95% CI, 1.2-1.7), and abdominal surgery (estimated AOR, 1.4; 95% CI, 1.1-1.7). Eighty percent of hypoglycemia occurred in children <5 years of age and in children <20 kg. CONCLUSIONS: Young age, weight for age <5th percentile, ASA status ≥III, having a gastric or jejunal tube, poor feeding, and abdominal surgery were risk factors for intraoperative hypoglycemia in children. Monitoring of blood glucose is recommended in these subsets of children.
Riegger et al. (Thu,) conducted a cohort in Intraoperative hypoglycemia (n=26,142). Age <30 days vs. Age ≥5 years was evaluated on Blood glucose <60 mg/dL (3.3 mmol/L) (AOR 4.2, 95% CI 3.4-5.3). Age <30 days was a strong independent predictor of intraoperative hypoglycemia compared to age ≥5 years (AOR 4.2; 95% CI 3.4-5.3), along with low weight, ASA ≥III, and abdominal surgery.
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