Prognostic implications of hyperglycaemia in paediatric head injury.
Fifty children with head injury were evaluated in an attempt to establish a correlation between post-traumatic hyperglycaemia and long-term outcome. In all the patients, the blood glucose level was measured on admission and on the days following the trauma (threshold of normal value set at 150 mg/dl). Hyperglycaemia was seen more frequently in children with severe head injury than in those with mild and moderate head injury. It was present in 87.5% of the patients with a Glasgow Coma Score (GCS) < or =8 (the average blood glucose level on admission was 237.8+/-92 mg/dl), in 60% of the patients with a GCS of 9-12 (178+/-78.7 mg/dl) and only in 25% of those with a GCS of 13-15 (131.5+/-39 mg/dl). A close correlation was also seen between the outcome and the blood glucose level. In fact, the blood glucose on admission was higher in the patients with a poor outcome, i.e. in those having a Glasgow Outcome Score (GOS) of 2 or 3 and in those who died (GOS 1), than in the patients with a good outcome (GOS of 4 or 5). Finally, hyperglycaemia persisted beyond the first 24 h after trauma in all the children who died or who survived with a poor outcome. Hyperglycaemia, and especially its persistence over time, appears to be an important negative prognostic factor in children with head injury.
Chiaretti
A
A
Paediatric Intensive Care Unit, Institute of Paediatrics, Catholic University, Rome, Italy.
De Benedictis
R
R
Langer
A
A
Di Rocco
C
C
Bizzarri
C
C
Iannelli
A
A
Polidori
G
G
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000097:blood / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D006233:Persons with Disabilities; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology*; D007223:Infant; D008297:Male; D018458:Persistent Vegetative State / Q000209:etiology; D011379:Prognosis; D016019:Survival Analysis
D001786:Blood Glucose