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Admission hyperglycemia as a prognostic indicator in trauma
Saikrishna Yendamuri1, Gerard J Fulda, Glen H Tinkoff
1Department of Surgery, Christian Care Health Services, Newark, Delaware, USA.
The Journal of Trauma
|July 12, 2003
Summary
Mild and moderate hyperglycemia in trauma patients independently predict increased mortality and infectious complications. Even mild elevations in blood glucose levels (over 135 mg/dL) are associated with worse outcomes.
Area of Science:
- Trauma care
- Endocrinology
- Critical care medicine
Background:
- Hyperglycemia is common in trauma patients.
- The prognostic significance of varying degrees of hyperglycemia in trauma is not fully understood.
Purpose of the Study:
- To evaluate the predictive value of two hyperglycemia thresholds for mortality and infectious morbidity in trauma patients.
Main Methods:
- Retrospective review of adult trauma patients admitted to a Level I trauma center.
- Categorization of hyperglycemia into mild (>135 mg/dL) and moderate (>200 mg/dL) based on admission glucose levels.
- Exclusion of hypoglycemic patients.
Main Results:
- Hyperglycemia, both mild and moderate, was significantly associated with increased mortality compared to normoglycemic groups.
- Hyperglycemia independently predicted mortality, hospital length of stay, and intensive care unit length of stay.
- Increased infectious complications including pneumonia, urinary tract infections, wound infections, and bacteremia were observed in hyperglycemic patients.
Conclusions:
- Admission hyperglycemia, even at mild levels, is an independent predictor of mortality and infectious morbidity in trauma patients.
- Hyperglycemia is associated with longer hospital and intensive care unit stays.
- These findings underscore the importance of monitoring and managing blood glucose levels in trauma care.