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
. 2016 Sep 26:9:43-46.
doi: 10.4137/CMED.S40330. eCollection 2016.

Hyperglycemia: A Predictor of Death in Severe Head Injury Patients

Simin Babaie Kafaki  1 , Kamaledin Alaedini  1 , Ashkan Qorbani  2 , Leila Asadian  1 , Kaveh Haddadi  3
Affiliations

Hyperglycemia: A Predictor of Death in Severe Head Injury Patients

Simin Babaie Kafaki et al. Clin Med Insights Endocrinol Diabetes. .

Abstract

Objectives: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU).

Methods: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012-2015. After screening 311 patients, 220 were included in the study. Both blood glucose and HbA1c levels of all the patients at admission, as well as blood glucose level after 72 hours, were obtained from the records. The patients were later grouped based on their admission blood glucose levels (<200 mg/dL or ≥200 mg/dL). Injury severity score (ISS) was documented for every patient. As a final point, the outcomes were determined based on the hospital length of stay (HLS) and ICU length of stay (ILS), plusmortality rates.

Results: About 39% (n = 85) of patients were admitted with hyperglycemia during the study period. The mortality rate in patients with glucose ≥200 mg/dL was 65.8% (N = 56), against 23.7% (N = 32) in the group with glucose <200 mg/dL, with mortality rising as the blood glucose level increased (P = 0.014).

Conclusions: We conclude that admission hyperglycemia is related with increased mortality rate in head injury patients, and comprehensive treatment of hyperglycemia can improve the outcome of severe head injury patients.

Keywords: hyperglycemia; injury severity score; mortality.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The relationship between blood glucose level in the first 24 hours in ICU and mortality. Abbreviation: ICU, intensive care unit.
See this image and copyright information in PMC

References

    1. Belli A, Sen J, Petzold A, Russo S, Kitchen N, Smith M. Metabolic failure precedes intracranial pressure rises in traumatic brain injury: a microdialysis study. Acta Neurochir (Wien) 2008;150:461–469. - PubMed
    1. Senkowski CK, McKenney MG. Trauma scoring systems: a review. J Am Coll Surg. 1999;189(5):491–503. - PubMed
    1. Van Camp LA, Delooz HH. Current trauma scoring systems and their applications. Eur J Emerg Med. 1998;5(3):341–353. - PubMed
    1. Pomposelli JJ, Baxter JK, III, Babineau TJ, et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN J Parenter Enteral Nutr. 1998;22(2):77–81. - PubMed
    1. Golden SH, Peart-Vigilance C, Kao WH, Brancati FL. Perioperative glycemic control and the risk of infectious complicationsin a cohort of adults with diabetes. Diabetes Care. 1999;22(9):1408–1414. - PubMed

LinkOut - more resources