Author/Authors :
Alvis-Miranda، Hernando نويسنده University of Cartagena, Colombia , , Navas-Marrugo، Sandy Zuleica نويسنده Department of Neurosurgery, University of Cartagena, Cartagena de Indias, Colombia, South America , , Velasquez-Loperena، Robert Andrés نويسنده Department of Medicine, University of Magdalena, Colombia, South America , , Adie-Villafa?e، Richard José نويسنده Department of Neurosurgery, University of Cartagena, Cartagena de Indias, Colombia, South America , , Velasquez-Loperena، Duffay نويسنده Department of Medicine, University of Magdalena, Colombia, South America , , Castellar-Leones، Sandra Milena نويسنده University of Cartagena, Colombia , , Alcala-Cerra، Gabriel نويسنده University of Cartagena, Cartagena de Indias, Colombia, South America , , Pulido-Gutiérrez، Juan Camilo نويسنده National University of Colombia, Bogota, Colombia , , Rodr?guez-Conde، Javier Ricardo نويسنده National University of Colombia, Bogota, Colombia , , Moreno-Moreno، Mar?a Fernanda نويسنده National University of Colombia, Bogota, Colombia , , Rubiano، Andres M. نويسنده Hospital Universitario de Neiva, Huila, Colombia , , Moscote-Salazar، Luis Rafael نويسنده Department of Neurosurgery, University of Cartagena, Colombia ,
Abstract :
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 admitted
to 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 glucose
level was determined in the first 24 hours of admission were included. Adults older than 85 years, with absence
of Glasgow Coma Scale (GCS) score and a brain Computerized Tomography (CT) scans were excluded. The
cut-off value was considered 200 mg/dL to define hyperglycemia. Final GCS, hospital admission duration and
complications were compared between normoglycemic and hyperglycemic patients.
Results: Totally 217 patients were identified with TBI. Considering exclusion criteria, 89 patients remained for
analysis. The mean age was 43.0±19.6 years, the mean time of remission was 5.9±9.4 hours, the mean GCS on
admission was 10.5±3.6 and the mean blood glucose level in the first 24 hours was 138.1±59.4 mg/dL. Hyperglycemia
was 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 glucose
level at admission were managed only medically, whereas surgical treatment was more frequent in patients with
hyperglycemia (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 with
traumatic brain injury.
