Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Apr;2(2):65-71.

Effects of Glycemic Level on Outcome of Patients with Traumatic Brain Injury: A Retrospective Cohort Study

Hernando Raphael Alvis-Miranda  1 , Sandy Zuleica Navas-Marrugo  1 , Robert Andrés Velasquez-Loperena  2 , Richard José Adie-Villafañe  1 , Duffay Velasquez-Loperena  2 , Sandra Milena Castellar-Leones  1 , Gabriel Alcala-Cerra  1 , Juan Camilo Pulido-Gutiérrez  3 , Javier Ricardo Rodríguez-Conde  3 , María Fernanda Moreno-Moreno  3 , Andrés M Rubiano  4 , Luis Rafael Moscote-Salazar  1
Affiliations

Effects of Glycemic Level on Outcome of Patients with Traumatic Brain Injury: A Retrospective Cohort Study

Hernando Raphael Alvis-Miranda et al. Bull Emerg Trauma. 2014 Apr.

Abstract

Objective: To determine the effects of glycemic level on outcome patients with traumatic brain injury.

Methods: From September 2010 to December 2012, all medical records of adult patients with TBI admitted to the Emergency Room of Laura Daniela Clinic in Valledupar City, Colombia, South America were enrolled. Both genders between 18 and 85 years who referred during the first 48 hours after trauma, and their glucose level was determined in the first 24 hours of admission were included. Adults older than 85 years, with absence of Glasgow Coma Scale (GCS) score and a brain Computerized Tomography (CT) scans were excluded. The cut-off value was considered 200 mg/dL to define hyperglycemia. Final GCS, hospital admission duration and complications were compared between normoglycemic and hyperglycemic patients.

Results: Totally 217 patients were identified with TBI. Considering exclusion criteria, 89 patients remained for analysis. The mean age was 43.0±19.6 years, the mean time of remission was 5.9±9.4 hours, the mean GCS on admission was 10.5±3.6 and the mean blood glucose level in the first 24 hours was 138.1±59.4 mg/dL. Hyperglycemia was present in 13.5% of patients. The most common lesions presented by patients with TBI were fractures (22.5%), hematoma (18.3%), cerebral edema (18.3%) and cerebral contusion (16.2%). Most of patients without a high glucose level at admission were managed only medically, whereas surgical treatment was more frequent in patients with hyperglycemia (p=0.042). Hyperglycemia was associated with higher complication (p=0.019) and mortality rate (p=0.039). GCS was negatively associated with on admission glucose level (r=0.11; p=0.46).

Conclusion: Hyperglycemia in the first 24-hours of TBI is associated with higher rate of surgical intervention, higher complication and mortality rates. So hyperglycemia handling is critical to the outcome of patients with traumatic brain injury.

Keywords: Hyperglycemia; Polytrauma; Traumatic brain injury.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Guzmán F. Physiopathology of traumatic brain injury. Colombia Médica. 2008;39(3):78–84.
    1. Wegner A, Wilhelm J, Darras E. Traumatic brain injury physiological and physiopathological concepts for a rational management. Rev chil pediatr. 2003;74(1):16–30.
    1. Sharma D, Vavilala MS. Perioperative management of adult traumatic brain injury. Anesthesiol Clin. 2012;30(2):333–46. - PMC - PubMed
    1. Godoy DA, Di Napoli M, Rabinstein AA. Treating hyperglycemia in neurocr itical patients: benefits and p er i ls. Neurocr it Care. 2010;13(3):425–38. - PubMed
    1. Nordström CH, Rehncrona S, Siesjö BK. Restitution of cerebral energy state after complete and incomplete ischemia of 30 min duration. Acta Physiologica Scandinavica. 1976;97(2):270–2.

LinkOut - more resources