Correlation of blood sugar levels, serum cortisol levels, and outcome in critically ill children

Background: Hyperglycemia occurs due to acute stress in critically ill patients, and this can be attributed to an intricate pathophysiological pathway involving the elevation of counter-regulatory hormones like catecholamines, cortisol, glucagon, and proinflammatory cytokines. This study aims to explore the correlation between blood sugar levels and serum cortisol levels in critically ill children. Methods: This research is a cross-sectional study involving 80 critically ill children treated at the hospital from November 2023 until February 2024. Dr. Wahidin Sudirohusodo, Makassar. Blood sugar levels and serum cortisol levels measured during the observation period were correlated with critical illness according to the Pediatric Early Warning Signs (PEWS) score. Results: Glucose levels were found to have no significant relationship with cortisol levels (p=0.640) and PEWS scores (p=0.116). Meanwhile, cortisol levels showed a significant relationship to PEWS scores with a positive correlation (r=0.325, p=0.003). ROC analysis showed that serum cortisol levels (cut off 42.24 ng/ml) and PEWS score (cut off 5.5) were good predictors of mortality. Multivariate logistic regression analysis showed that cortisol levels as an independent risk factor predicted mortality in critically ill children (p=0.000). Conclusion: An increase in serum cortisol levels is directly proportional to an increase in the PEWS score, which indicates that an increase in blood serum cortisol levels increases the risk of death in critically ill children.