IP Indian Journal of Neurosciences


Admission serum glucose level as a marker of outcome severe head injury patients


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Author Details: Raghavendra Nayak,Bhagwati Salgotra*,Dhruv N. Patel,Marci Juneja,Deval Patel

Volume : 4

Issue : 4

Online ISSN : 2581-916X

Print ISSN : 2581-8236

Article First Page : 209

Article End Page : 211


Abstract

Introduction: Hyperglycemia is a one of the common response to stress especially when it is related to the tissue injury like head injury. The purpose of this study was to detect the effect of admission hyperglycemia on the overall mortality and morbidity in the patients of severe head injury.
Materials and Methods: Retrospective methods were used in this study and this study includes patients with severe TBI. The patients were divided into two groups: Hyperglycemia group and normal blood sugar level group. This was based on the serum glucose level. The Outcome measures of the study were mortality and Glasgow Outcome Scale which were recorded at 6 months.
Results: A total of 160 patients (male = 112, female = 48) were included in this study who had severe TBI and also met the inclusion criteria. The mean (±SD) age of the patients taken for this study was 46.5 (±11.5) years. The mean GCS of the patients at the time of admission was 5.2 ± 1.5. The mean (±SD) serum glucose level within 24 hours of admission was 249 mg/dL with lowest being 110 mg/dL and highest of 390 mg/dL. Fifty-five (34%) patients had hyperglycemia (glucose level >200mg/dL) at admission and remaining 105 patients (66%) had normal serum magnesium levels. Hyperglycemia resulted in 55% of the total mortality (N = 30) compared to 38% (N=40) in patients who had normal blood glucose level after 24 hours of admission. The mortality rate is significantly higher in patients with hyperglycemia (?2 = 3.68; P = 0.04). The assessment of the patients with Glasgow outcome score was done at 6 months follow up. 80% (N=44) of the patients who had high blood sugar levels showed the poor Glasgow outcome compared to the patients with normal blood glucose where 66% (N=65) which was statistically significant (?2 =5.44; p= .019).
Conclusion: Hyperglycemia at admission increases the rate of mortality and morbidity in head injury patients.
 

Keywords:  Hyperglycemia, Severe head injury, Glasgow outcome scale.

Doi :-https://doi.org/10.18231/2455-8451.2018.0048