Persistent hyperglycemia in severe traumatic brain injury

An independent predictor of outcome

Ali Salim, Pantelis Hadjizacharia, Joseph Dubose, Carlos Brown, Kenji Inaba, Linda S. Chan, Daniel Margulies

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)25-29
Number of pages5
JournalAmerican Surgeon
Volume75
Issue number1
StatePublished - Jan 2009

Fingerprint

Hyperglycemia
Craniocerebral Trauma
Intensive Care Units
Blood Glucose
Mortality
Traumatic Brain Injury
Trauma Centers
Wounds and Injuries
Length of Stay
Logistic Models
Odds Ratio
Regression Analysis
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Surgery

Cite this

Salim, A., Hadjizacharia, P., Dubose, J., Brown, C., Inaba, K., Chan, L. S., & Margulies, D. (2009). Persistent hyperglycemia in severe traumatic brain injury: An independent predictor of outcome. American Surgeon, 75(1), 25-29.

Persistent hyperglycemia in severe traumatic brain injury : An independent predictor of outcome. / Salim, Ali; Hadjizacharia, Pantelis; Dubose, Joseph; Brown, Carlos; Inaba, Kenji; Chan, Linda S.; Margulies, Daniel.

In: American Surgeon, Vol. 75, No. 1, 01.2009, p. 25-29.

Research output: Contribution to journalArticle

Salim, A, Hadjizacharia, P, Dubose, J, Brown, C, Inaba, K, Chan, LS & Margulies, D 2009, 'Persistent hyperglycemia in severe traumatic brain injury: An independent predictor of outcome', American Surgeon, vol. 75, no. 1, pp. 25-29.
Salim A, Hadjizacharia P, Dubose J, Brown C, Inaba K, Chan LS et al. Persistent hyperglycemia in severe traumatic brain injury: An independent predictor of outcome. American Surgeon. 2009 Jan;75(1):25-29.
Salim, Ali ; Hadjizacharia, Pantelis ; Dubose, Joseph ; Brown, Carlos ; Inaba, Kenji ; Chan, Linda S. ; Margulies, Daniel. / Persistent hyperglycemia in severe traumatic brain injury : An independent predictor of outcome. In: American Surgeon. 2009 ; Vol. 75, No. 1. pp. 25-29.
@article{a621eb1ec69742dd941ad33600399b97,
title = "Persistent hyperglycemia in severe traumatic brain injury: An independent predictor of outcome",
abstract = "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.",
author = "Ali Salim and Pantelis Hadjizacharia and Joseph Dubose and Carlos Brown and Kenji Inaba and Chan, {Linda S.} and Daniel Margulies",
year = "2009",
month = "1",
language = "English (US)",
volume = "75",
pages = "25--29",
journal = "American Surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "1",

}

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

Y1 - 2009/1

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.

UR - http://www.scopus.com/inward/record.url?scp=61449171141&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61449171141&partnerID=8YFLogxK

M3 - Article

VL - 75

SP - 25

EP - 29

JO - American Surgeon

JF - American Surgeon

SN - 0003-1348

IS - 1

ER -