The association between severely deranged vital signs and Dysglycaemia in severely ill children admitted to Queen Elizabeth Central Hospital (QECH), Blantyre Malawi
Loading...
Date
2021-07-01
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kamuzu University of Health Sciences
Abstract
Abnormal blood glucose level commonly occurs in children presenting to the hospitals in low
income settings. The presence of low blood glucose levels could be a marker of disease severity.
Vital signs are routinely checked in sick children and most settings use a combination of
deranged vital signs to determine disease severity. Blood glucose is a quick, bed side test and
could serve as a complementary indicator of disease severity in low resource settings. The study
aims to determine the association between the presence of severely deranged vital signs and
dysglycaemia in severely ill children admitted to a tertiary hospital in Malawi. This was a crosssectional
study which used secondary data from Paediatric department collected from December
2016 to January 2019. Multinomial logistic regression was used to determine the association
between severely deranged vital signs and dysglycaemia. A total of 5247 children, aged 0 to
18years were recruited into the study. 353(6.7%) had lowglycaemia,105(2.0%) had
hypoglycaemia and 771(14.7%) had hyperglycaemia. The presence of any severely deranged
vital sign, specifically, hypoxia (oxygen saturation <90%) and coma score of<2 were associated
with both hypoglycaemia and hyperglycaemia. The Adjusted Odds Ratio (AOR) for the
association of any severely deranged vital sign with hypoglycaemia was 1.76(95% CI 1.2–2.6)
and 1.5(95% CI 1.3–1.8) with hyperglycaemia. Hypoxia had odds ratio of 2.0(95% CI 1.2–3.4)
for hypoglycaemia and 1.5 (95% CI 1.2–1.9) for hyperglycaemia whilst for reduced coma score
the odds was 6.5(95% CI 4.2–10.2) and 2.3(95% CI 1.8–2.9) respectively.
The results have shown that the presence of any severely deranged vital sign is associated with
dysglycaemia especially hypoglycaemia and hyperglycaemia. As such dysglycaemia might be
used as a complementary marker of disease severity in low resource settings.