Hyperglycemia and outcomes from pediatric traumatic brain injury.
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 > or = 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 > or = 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.
Cochran
Amalia
A
Department of Surgery, University of Utah, Salt Lake City, USA.
Scaife
Eric R
ER
Hansen
Kristine W
KW
Downey
Earl C
EC
D015998:Abbreviated Injury Scale; D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000032:analysis; D001930:Brain Injuries / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D020208:Brain Injury, Chronic / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006776:Hospitals, Pediatric; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007223:Infant; D015601:Injury Severity Score; D016015:Logistic Models; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014589:Utah / Q000453:epidemiology
D001786:Blood Glucose