title: Association between Hyperglycaemia with Neurological Outcomes Following Severe Head Trauma.
abstract: BACKGROUND
  Head Trauma (HT) is a major cause of death, disability and important public health problem. HT is also the main cause of hyperglycaemia that can increase mortality.
  
  
  OBJECTIVE
  The aim of this study was to assess the correlation between hyperglycaemia with neurological outcomes following severe Traumatic Brain Injury (TBI).
  
  
  METHODS
  This is a descriptive and correlation study that was carried out at the Imam Khomeini Hospital affiliated with Ilam University of Medical Sciences, Ilam, IR, during March 2014-March 2015 on patients with severe TBI. Data were collected from the patient records on mortality, Intensive Care Unit (ICU) length of stay, hospital length of stay, admission GCS score, Injury Severity Score (ISS), mechanical ventilation, Ventilation Associated Pneumonia (VAP) and Acute Respiratory Distress Syndrome (ARDS). Random Blood Sugar (RBS) level on admission was recorded. Patients with diabetes mellitus (to minimize the overlap between acute stress hyperglycaemia and diabetic hyperglycaemia) were excluded.
  
  
  RESULTS
  About 34(40%) of patients were admitted with hyperglycaemia (RBS ≥ 200 mg/dl) over the study period. The mortality rate, length of ICU stay, hospital stay, ISS and VAP & ARDS in patients with RBS levels ≥ 200 mg was significantly higher than patients with RBS levels below ≤ 200mg (p<0.05, p<0.001). A significant correlation was found between RBS with GCS arrival, length of ICU stay, length of hospital stay, ISS, mechanical ventilation and VAP & ARDS (p<0.05, p< 0.001). RBS is a predicate factor for ISS (p <0.05, OR : 1.36), GCS (p <0.001, OR : 1.69), mechanical ventilation (p< 0.05, OR : 1.27), VAP & ARDS (p <0.001, OR : 1.68), length of ICU stay (p <0.001, OR : 1.87) and length of hospital stay (p <0.05, OR : 1.24).
  
  
  CONCLUSIONS
  Hyperglycaemia after severe TBI (RBS ≥ 200) is associated with poor outcome. It can be a predictive factor for mortality rate, ICU stay, GCS arrival, VAP & RDS, hospital stay and ISS. Management of hyperglycaemia with insulin protocol in cases with value >200mg/dl, is critical in improving the outcome of patients with TBI.
authors.affiliation: Anaesthesiologist, Department of Anaesthesiology, Medicine Faculty, Ilam University of Medical Science , Ilam, IR-Iran .
authors.forename: Javaher
authors.initials: J
authors.lastname: Khajavikhan
authors.affiliation: Anaesthesiologist, Department of Anaesthesiology, Medicine Faculty, Ilam University of Medical Science , Ilam, IR-Iran .
authors.forename: Aminolah
authors.initials: A
authors.lastname: Vasigh
authors.affiliation: Student, Department of Nursing, Nursing & Midwifery Faculty, Ilam University of Medical Science , Ilam, IR-Iran .
authors.forename: Taleb
authors.initials: T
authors.lastname: Kokhazade
authors.affiliation: Student, Department of Nursing, Nursing & Midwifery Faculty, Ilam University of Medical Science , Ilam, IR-Iran .
authors.forename: Ali
authors.initials: A
authors.lastname: Khani
keywords: Critical Care; Head injury; Icu; Serum glucose; Traumatic brain injury