title: Effect of diabetes mellitus on outcome in patients with traumatic brain injury: a national trauma databank analysis.
abstract: BACKGROUND
  Diabetes mellitus (DM) is associated with worsened outcomes following severe injury. However, clinical studies evaluating the effect of DM on outcomes in patients suffering traumatic brain injury (TBI) are currently lacking.
  
  
  METHODS
  This was a National Trauma Databank (NTDB) study over a 5-year period. Patients with DM were matched with victims of isolated TBI without DM in a 1:2 ratio. Outcomes included mortality, hospital and surgical intensive care unit (SICU) length of stay, ventilator days and discharge disposition.
  
  
  RESULTS
  Of the 35,005 patients with isolated TBI, 636 (1.8%) cases had documented DM. After matching 1272 counterparts without DM, no differences with regards to demographic and injury characteristics were observed comparing the two groups. Overall mortality in the study population was 18.8% (n = 358), with a significantly increased in-hospital mortality in patients with vs without DM [22.6% vs. 16.8%; OR (95% CI): 1.45 (1.14-1.83); p = 0.002]. Patients with DM were significantly less frequently discharged home compared to their counterparts without DM [38.9% vs 46.1%; OR (95% CI): 0.75 (0.60-0.93); p = 0.008].
  
  
  CONCLUSIONS
  Traumatic brain injury in conjunction with diabetes mellitus is associated with an almost 1.5-fold increased mortality while compared to patients with isolated TBI without diabetes mellitus. Prospective validation of these findings is warranted to determine the underlying aetiology.
authors.affiliation: Division of Acute Care Surgery (Trauma, Emergency Surgery and Surgical Critical Care), Department of Surgery, Keck School of Medicine, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA 90033-4525, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lustenberger
authors.forename: Peep
authors.initials: P
authors.lastname: Talving
authors.forename: Lydia
authors.initials: L
authors.lastname: Lam
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Margarita
authors.initials: M
authors.lastname: Bass
authors.forename: David
authors.initials: D
authors.lastname: Plurad
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D017677:Age Distribution; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000401:mortality* / Q000534:rehabilitation; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D023261:Glasgow Outcome Scale; D020197:Head Injuries, Penetrating / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality*