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Association of persistent hyperglycemia with outcome of severe traumatic brain injury in pediatric population

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Abstract

Purpose

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).

Conclusion

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.

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Acknowledgments

The authors appreciate the insightful cooperations of Guilan Trauma Research Center and Poursina Hospital staffs. The authors thank the patients and families who participated in this study.

Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Medical Students Research Committee, Guilan University of Medical Sciences, Rasht, Iran

    Seyed Mohammad Seyed Saadat, Seyedeh Nazanin Seyed Saadat & Fatemeh Salamat

  2. Department of Neurosurgery, Arya Hospital, Rasht, Iran

    Mehryar Mashouf

  3. Department of Neurosurgery, Poursina Hospital, Rasht, Iran

    Shahrokh Yousefzadeh

  4. Guilan University of Medical Sciences, No. 15-135 Ave.—Golsar, Rasht, 4165855695, Iran

    Elham Bidabadi

Authors
  1. Seyed Mohammad Seyed Saadat
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  2. Elham Bidabadi
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  3. Seyedeh Nazanin Seyed Saadat
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  4. Mehryar Mashouf
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  5. Fatemeh Salamat
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  6. Shahrokh Yousefzadeh
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Corresponding author

Correspondence to Elham Bidabadi.

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Seyed Saadat, S.M., Bidabadi, E., Seyed Saadat, S.N. et al. Association of persistent hyperglycemia with outcome of severe traumatic brain injury in pediatric population. Childs Nerv Syst 28, 1773–1777 (2012). https://doi.org/10.1007/s00381-012-1753-5

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  • DOI: https://doi.org/10.1007/s00381-012-1753-5

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