title: Association of persistent hyperglycemia with outcome of severe traumatic brain injury in pediatric population.
abstract: OBJECTIVE
  Hyperglycemia is a common secondary insult associated with an increased risk of mortality and poor outcome in traumatic brain injury (TBI), but the effect of hyperglycemia on outcomes of severe TBI in children and adolescents is less apparent. The aim of this study was to evaluate the association of hyperglycemia with mortality in pediatric patients with severe TBI.
  
  
  METHODS
  In this cross-sectional study, data of all children and adolescents with severe TBI admitted to Poursina Hospital in Rasht, including age, gender, Glasgow Coma Scale (GCS) upon admission, mortality rate, hospital length of stay, and serial blood glucose during the first three consecutive ICU days following admission, were reviewed from April 2007 to May 2011. After univariate analysis and adjustment for related covariates, logistic regression model was established to determine the association between persistent hyperglycemia and outcome.
  
  
  RESULTS
  One-hundred and twenty-two children were included with a median admission GCS of 6 (interquartile range (IQR) 5-7) and a median age of 13 years (IQR 7.75-17). Among them, 91 were boys (74.6%) and 31 were girls (26.6%); the overall mortality was 40.2% (n=49). Patients who died had a significantly greater blood glucose levels than survivors for the first 3 days of admission (P=0.003, P<0.001, P=0.001, respectively). Moreover, persistent hyperglycemia during the first 3 days of admission had an adjusted odds ratio of 11.11 for mortality (P<0.001).
  
  
  CONCLUSIONS
  Early hyperglycemia is associated with poor outcome, and persistent hyperglycemia is a powerful and independent predictor of mortality in children and adolescents with severe TBI.
authors.affiliation: Medical Students Research Committee, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Seyed Saadat
authors.forename: Elham
authors.initials: E
authors.lastname: Bidabadi
authors.forename: Seyedeh Nazanin
authors.initials: SN
authors.lastname: Seyed Saadat
authors.forename: Mehryar
authors.initials: M
authors.lastname: Mashouf
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Salamat
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Yousefzadeh
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001930:Brain Injuries / Q000097:blood / Q000150:complications* / Q000401:mortality; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology* / Q000401:mortality; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016017:Odds Ratio; D010372:Pediatrics; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D001786:Blood Glucose