Hyperglycemia and Outcomes from Pediatric Traumatic Brain... : Journal of Trauma and Acute Care Surgery (original) (raw)

ORIGINAL ARTICLES

Cochran, Amalia MD; Scaife, Eric R. MD; Hansen, Kristine W. RN, BSN; Downey, Earl C. MD

From the Department of Surgery, University of Utah (A.C., E.R.S., E.C.D.), Intermountain Injury Control Research Center, University of Utah School of Medicine (A.C.), and Division of Pediatric Surgery, Primary Children’s Medical Center (E.R.S., K.W.H., E.C.D.), Salt Lake City, Utah.

Submitted for publication May 28, 2002.

Accepted for publication July 8, 2002.

Address for reprints: Eric R. Scaife, MD, Division of Pediatric Surgery, Primary Children’s Medical Center, Salt Lake City, UT 84113; email: [email protected].

The Journal of Trauma: Injury, Infection, and Critical Care 55(6):p 1035-1038, December 2003. | DOI: 10.1097/01.TA.0000031175.96507.48

Abstract

Background

The clinical significance of hyperglycemia after pediatric traumatic brain injury is controversial. This study addresses the relationship between hyperglycemia and outcomes after traumatic brain injury in pediatric patients.

Methods

We identified trauma patients admitted during a single year to our regional pediatric referral center with head regional Abbreviated Injury Scale scores ≥ 3. We studied identified patients for admission characteristics potentially influencing their outcomes. The primary outcome measure was Glasgow Outcome Scale score.

Results

Patients who died had significantly higher admission serum glucose values than those patients who survived (267 mg/dL vs. 135 mg/dL; p = 0.000). Admission serum glucose ≥ 300 mg/dL was uniformly associated with death. Admission Glasgow Coma Scale score (odds ratio, 0.560; 95% confidence interval, 0.358–0.877) and serum glucose (odds ratio, 1.013; 95% confidence interval, 1.003–1.023) are independent predictors of mortality in children with traumatic head injuries.

Conclusion

Hyperglycemia and poor neurologic outcome in head-injured children are associated. The pathophysiology of hyperglycemia in neurologic injury after head trauma remains unclear.