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Relationship between serum glucose and injury severity score in childhood trauma
W J Pomerantz1, P J Hashkes, P A Succop
1Children's Hospital Medical Center and University of Cincinnati College of Medicine, Ohio 45229, USA.
Insights
Initial high serum glucose levels correlate with increased injury severity in pediatric trauma patients. This association is particularly pronounced in children under two years old, suggesting glucose as a potential indicator of trauma severity.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Care
- Biochemistry
Background:
- Pediatric multiple trauma presents unique challenges in assessment.
- Early indicators of injury severity are crucial for timely intervention.
- Serum glucose levels can be influenced by physiological stress.
Purpose of the Study:
- To investigate the association between initial serum glucose and Injury Severity Score (ISS) in pediatric patients with multiple trauma.
- To determine if serum glucose can serve as a predictive marker for trauma severity in children.
Main Methods:
- Retrospective chart review of 185 pediatric patients (0-19 years) admitted with acute multiple trauma.
- Data collected included initial serum glucose, heart rate, systolic blood pressure, ISS, age, gender, and interventions.
- Multiple linear regression analysis was employed to assess relationships, adjusting for confounding factors.
Main Results:
- A significant direct relationship was observed between initial serum glucose and ISS (r = 0.52, P < .01) after adjusting for covariates.
- This correlation was stronger in younger children (less than 2 years old) (r = 0.60, P = .04).
- Mean ISS was 11.3 and mean glucose was 162.8 mg/dL.
Conclusions:
- Initial serum glucose is a significant predictor of injury severity in children with multiple trauma.
- Elevated glucose levels may indicate more severe injuries, especially in infants and toddlers.
- Further research could explore the clinical utility of glucose monitoring in pediatric trauma triage.
Purpose:
The aim of this study was to examine the relationship between initial serum glucose and injury severity score (ISS) in children with multiple trauma.
Methods:
Charts from all patients 0 to 19 years of age admitted to a children's hospital in 1995 with acute multiple trauma were reviewed. Data collected included initial serum glucose level, heart rate (HR), systolic blood pressure (SBP), Injury Severity Score (ISS), age, gender, location of trauma, and need for intravenous fluids or epinephrine. Data were analyzed using multiple linear regression.
Results:
A total of 185 charts were reviewed. The mean ISS was 11.3; the mean glucose was 162.8 mg/dL. After adjusting for age, gender, HR, SBP, and administration of epinephrine or fluid bolus, a significant direct relationship between serum glucose and ISS was found (r = 0.52, P < .01). A stronger relationship was found in children less than 2 years old (r = 0.60, P = .04).
Conclusions:
A significant direct relationship exists between glucose and ISS in children with multiple trauma. High glucose values may indicate more severe injury, especially in children less than 2 years old.