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Hyperglycemia: A Predictor of Death in Severe Head Injury Patients

OBJECTIVES: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperg...

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Autores principales: Kafaki, Simin Babaie, Alaedini, Kamaledin, Qorbani, Ashkan, Asadian, Leila, Haddadi, Kaveh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Libertas Academica 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038612/
https://www.ncbi.nlm.nih.gov/pubmed/27695379
http://dx.doi.org/10.4137/CMED.S40330
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author Kafaki, Simin Babaie
Alaedini, Kamaledin
Qorbani, Ashkan
Asadian, Leila
Haddadi, Kaveh
author_facet Kafaki, Simin Babaie
Alaedini, Kamaledin
Qorbani, Ashkan
Asadian, Leila
Haddadi, Kaveh
author_sort Kafaki, Simin Babaie
collection PubMed
description OBJECTIVES: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU). METHODS: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012–2015. After screening 311 patients, 220 were included in the study. Both blood glucose and HbA1c levels of all the patients at admission, as well as blood glucose level after 72 hours, were obtained from the records. The patients were later grouped based on their admission blood glucose levels (<200 mg/dL or ≥200 mg/dL). Injury severity score (ISS) was documented for every patient. As a final point, the outcomes were determined based on the hospital length of stay (HLS) and ICU length of stay (ILS), plusmortality rates. RESULTS: About 39% (n = 85) of patients were admitted with hyperglycemia during the study period. The mortality rate in patients with glucose ≥200 mg/dL was 65.8% (N = 56), against 23.7% (N = 32) in the group with glucose <200 mg/dL, with mortality rising as the blood glucose level increased (P = 0.014). CONCLUSIONS: We conclude that admission hyperglycemia is related with increased mortality rate in head injury patients, and comprehensive treatment of hyperglycemia can improve the outcome of severe head injury patients.
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spelling pubmed-50386122016-09-30 Hyperglycemia: A Predictor of Death in Severe Head Injury Patients Kafaki, Simin Babaie Alaedini, Kamaledin Qorbani, Ashkan Asadian, Leila Haddadi, Kaveh Clin Med Insights Endocrinol Diabetes Original Research OBJECTIVES: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU). METHODS: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012–2015. After screening 311 patients, 220 were included in the study. Both blood glucose and HbA1c levels of all the patients at admission, as well as blood glucose level after 72 hours, were obtained from the records. The patients were later grouped based on their admission blood glucose levels (<200 mg/dL or ≥200 mg/dL). Injury severity score (ISS) was documented for every patient. As a final point, the outcomes were determined based on the hospital length of stay (HLS) and ICU length of stay (ILS), plusmortality rates. RESULTS: About 39% (n = 85) of patients were admitted with hyperglycemia during the study period. The mortality rate in patients with glucose ≥200 mg/dL was 65.8% (N = 56), against 23.7% (N = 32) in the group with glucose <200 mg/dL, with mortality rising as the blood glucose level increased (P = 0.014). CONCLUSIONS: We conclude that admission hyperglycemia is related with increased mortality rate in head injury patients, and comprehensive treatment of hyperglycemia can improve the outcome of severe head injury patients. Libertas Academica 2016-09-26 /pmc/articles/PMC5038612/ /pubmed/27695379 http://dx.doi.org/10.4137/CMED.S40330 Text en © 2016 the author(s), publisher and licensee Libertas Academica Ltd. This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.
spellingShingle Original Research
Kafaki, Simin Babaie
Alaedini, Kamaledin
Qorbani, Ashkan
Asadian, Leila
Haddadi, Kaveh
Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
title Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
title_full Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
title_fullStr Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
title_full_unstemmed Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
title_short Hyperglycemia: A Predictor of Death in Severe Head Injury Patients
title_sort hyperglycemia: a predictor of death in severe head injury patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038612/
https://www.ncbi.nlm.nih.gov/pubmed/27695379
http://dx.doi.org/10.4137/CMED.S40330
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