A systematic review and meta-analysis on glycemic control in traumatic brain injury

Ezequiel Garcia-Ballestas ¹, Javier Villafañe ², Karen Nuñez-Baez ³

⁰Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena de Indias, Colombia; Latinoamerican Council of Neurocritical Care, CLaNi, Cartagena de Indias, Bolívar, Colombia.

Clinical Neurology and Neurosurgery +

|

August 14, 2024

View abstract on PubMed

Summary

Intensive glycemic control in traumatic brain injury patients did not significantly alter mortality but improved clinical outcomes. Further research is needed to understand potential risks like hypoglycemia.

Area Of Science

Neuroscience
Critical Care Medicine
Endocrinology

Background

Hyperglycemia is linked to poor outcomes in traumatic brain injury (TBI).
Existing evidence supports intensive glycemic control for TBI patients.
This study evaluates the evidence for glycemic control's role in TBI.

Purpose Of The Study

To systematically review and meta-analyze the evidence on glycemic control in traumatic brain injury.
To assess the impact of intensive glycemic control on mortality and clinical outcomes in TBI patients.

Main Methods

Systematic review and meta-analysis adhering to PRISMA guidelines.
Inclusion of human studies on glycemic control in TBI.
Comprehensive literature search across major databases (PubMed, Embase, etc.) up to October 2020.
Risk of bias assessment using the GRADE quality Scale.

Main Results

Intensive glycemic control showed no significant difference in mortality versus conservative management (RR 0.99; p=0.92).
Intensive glycemic control reduced unfavorable clinical outcomes (RR 0.87; p=0.007).
Intensive glycemic control increased favorable clinical outcomes (RR 1.19; p=0.003).

Conclusions

Glycemic control's benefits may be offset by risks of hypoglycemia during intensive care.
Further research is required to fully elucidate the impact of glycemic control in TBI.

Keywords:

Conventional glycemic control Intensive glycemic control Traumatic brain injury