title: The impact of early hyperglycaemia on children with traumatic brain injury.
abstract: Hyperglycaemia is common amongst children with traumatic brain injury (TBI). We aim to investigate the association between early hyperglycaemia and poor clinical outcomes in children with moderate to severe TBI.
  
  
  
  We performed a retrospective study in a tertiary paediatric hospital between May 2012 and October 2014 of all patients with TBI who were aged <16 years with a Glasgow Coma Scale (GCS) of ≤13. The primary outcome was death. Secondary outcomes were 14 ventilation-free, 14 paediatric intensive care unit (PICU)-free and 28 hospital-free days. We defined hyperglycaemia as glucose >11.1 mmol/L (200 mg/dL).
  
  
  
  There were 109 patients with a median age of 54 months [inter-quartile range (IQR): 17-82]. Median glucose on arrival was 6.1 mmol/L (IQR: 5.2-9.8). Median GCS in our cohort was 8 (IQR: 6-12). Multivariate logistic regression demonstrated that initial hyperglycaemia [odds ratio (OR): 15.23; 95% confidence interval (CI): 3.74-62.00; P < 0.001], and GCS <8 (OR: 13.02; 95% CI: 2.31-73.33; P = 0.004) were risk factors for mortality. Multivariate linear regression showed that initial hyperglycaemia was a risk factor for reduced ventilation-free, PICU-free and hospital-free days.
  
  
  
  Early hyperglycaemia predicts for in-hospital mortality, reduced ventilation-free, PICU-free and hospital-free days in children with moderate to severe TBI.
authors.affiliation: a Department of Critical Care Medicine, Children's Hospital , Chongqing Medical University , Chongqing , China.
authors.forename: Yue-Qiang
authors.initials: YQ
authors.lastname: Fu
authors.affiliation: b Department of Children's Emergency , KK Women's and Children's Hospital , Singapore , Singapore.|c Duke-NUS Medical School , Singapore , Singapore.
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Chong
authors.affiliation: c Duke-NUS Medical School , Singapore , Singapore.|d Children's Intensive Care Unit , KK Women's and Children's Hospital , Singapore , Singapore.
authors.forename: Jan Hau
authors.initials: JH
authors.lastname: Lee
authors.affiliation: a Department of Critical Care Medicine, Children's Hospital , Chongqing Medical University , Chongqing , China.
authors.forename: Cheng-Jun
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: e Department of Paediatrics , KK Women's and Children's Hospital , Singapore , Singapore.
authors.forename: Sheng
authors.initials: S
authors.lastname: Fu
authors.affiliation: c Duke-NUS Medical School , Singapore , Singapore.|d Children's Intensive Care Unit , KK Women's and Children's Hospital , Singapore , Singapore.
authors.forename: Tsee Foong
authors.initials: TF
authors.lastname: Loh
authors.affiliation: b Department of Children's Emergency , KK Women's and Children's Hospital , Singapore , Singapore.|c Duke-NUS Medical School , Singapore , Singapore.
authors.forename: Kee Chong
authors.initials: KC
authors.lastname: Ng
authors.affiliation: a Department of Critical Care Medicine, Children's Hospital , Chongqing Medical University , Chongqing , China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology* / Q000401:mortality*; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Children; hyperglycaemia; mortality; paediatric; traumatic brain injury