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

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 admittedto 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 glucoselevel was determined in the first 24 hours of admission were included. adults older than 85 years, with absenceof glasgow coma scale (gcs) score and a brain computerized tomography (ct) scans were excluded. thecut-off value was considered 200 mg/dl to define hyperglycemia. final gcs, hospital admission duration andcomplications were compared between normoglycemic and hyperglycemic patients.results: totally 217 patients were identified with tbi. considering exclusion criteria, 89 patients remained foranalysis. the mean age was 43.0±19.6 years, the mean time of remission was 5.9±9.4 hours, the mean gcs onadmission was 10.5±3.6 and the mean blood glucose level in the first 24 hours was 138.1±59.4 mg/dl. hyperglycemiawas 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 glucoselevel at admission were managed only medically, whereas surgical treatment was more frequent in patients withhyperglycemia (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 withtraumatic brain injury.