The impact of early hyperglycaemia on children with traumatic brain injury. (23rd February 2017)

• Record Type: Journal Article
• Authors: Fu, Yue-qiang; Chong, Shu-Ling; Lee, Jan Hau; Liu, Cheng-jun; Fu, Sheng; Loh, Tsee Foong; Ng, Kee Chong; Xu, Feng
• Is Part Of: Brain injury. Volume 31:Number 3(2017)
• Page Start: 396
• Page End: 400
• Publication Date: 2017-02-23
• Subjects: Children -- hyperglycaemia -- mortality -- paediatric -- traumatic brain injury; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2016.1264629
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective : 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. Methods : 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). Results : 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. Conclusions : Early hyperglycaemia predicts for in-hospital mortality, reduced ventilation-free, PICU-free and hospital-free days in children with moderate to severe TBI.