TY - JOUR
T1 - Persistent hyperglycemia in severe traumatic brain injury
T2 - An independent predictor of outcome
AU - Salim, Ali
AU - Hadjizacharia, Pantelis
AU - Dubose, Joseph
AU - Brown, Carlos
AU - Inaba, Kenji
AU - Chan, Linda S.
AU - Margulies, Daniel
PY - 2009/1/1
Y1 - 2009/1/1
N2 - In patients with severe traumatic brain injury (TBI), admission hyperglycemia is associated with poor outcome. The effect of persistent hyperglycemia (PH) on outcome in severe TBI, however, remains unknown. We performed a retrospective review of all blunt trauma patients with severe TBI (head Abbreviated Injury Score ≥ 3) admitted to the intensive care unit at a Level I trauma center from January 1998 through December 2005. Admission and daily intensive care unit blood glucose levels up to the end of the first week were measured. PH was defined as an average daily blood glucose ≥ 150 mg/dL on all days for the first week of the hospital stay. TBI patients with and without PH were compared with respect to baseline demographics, injury characteristics, and outcomes. Independent risk factors for mortality were identified using logistic regression analysis. One hundred and five (12.6%) out of 834 severe TBI patients had PH. Patients with PH were older, more severely injured, and had worse head injury compared with patients without PH. After adjusting for significant risk factors, PH was identified as an independent risk factor for mortality (odds ratio (OR): 4.91 [95% confidence interval (CI), 2.88-8.56, P < 0.0001]). PH is associated with significantly higher mortality rates in severe TBI patients.
AB - In patients with severe traumatic brain injury (TBI), admission hyperglycemia is associated with poor outcome. The effect of persistent hyperglycemia (PH) on outcome in severe TBI, however, remains unknown. We performed a retrospective review of all blunt trauma patients with severe TBI (head Abbreviated Injury Score ≥ 3) admitted to the intensive care unit at a Level I trauma center from January 1998 through December 2005. Admission and daily intensive care unit blood glucose levels up to the end of the first week were measured. PH was defined as an average daily blood glucose ≥ 150 mg/dL on all days for the first week of the hospital stay. TBI patients with and without PH were compared with respect to baseline demographics, injury characteristics, and outcomes. Independent risk factors for mortality were identified using logistic regression analysis. One hundred and five (12.6%) out of 834 severe TBI patients had PH. Patients with PH were older, more severely injured, and had worse head injury compared with patients without PH. After adjusting for significant risk factors, PH was identified as an independent risk factor for mortality (odds ratio (OR): 4.91 [95% confidence interval (CI), 2.88-8.56, P < 0.0001]). PH is associated with significantly higher mortality rates in severe TBI patients.
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M3 - Article
C2 - 19213392
AN - SCOPUS:61449171141
SN - 0003-1348
VL - 75
SP - 25
EP - 29
JO - American Surgeon
JF - American Surgeon
IS - 1
ER -