Blood Glucose as a Prognostic Predictor of Traumatic Brain Injury in Patients That Underwent Surgical Intervention

Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. This study investigated the prognostic value of the initial blood glucose levels in surgically treated patients with TBI.

This prospective observational study included 90 patients with TBI who underwent surgery. Those with conditions affecting glucose metabolism, such as diabetes, were excluded. Blood glucose levels were measured on admission. Mortality and length of hospital stay were recorded, and correlations between glucose levels and outcomes were analyzed, including subgroup analyses according to TBI severity. Logistic regression was used to identify independent predictors and to control for confounding factors.

Mean initial blood glucose was 149.89 mg/dL. Overall, higher blood glucose levels were significantly correlated with longer hospital stay (r=0.320, p=0.002) and increased mortality (r=0.524, p<0.001). This correlation with mortality was particularly strong in moderate TBI (r=0.478, p<0.001), with a threshold of 148.5 mg/dL predicting increased mortality (area under the curve 0.807, p=0.001; sensitivity, 92.3%; specificity, 51.5%). Elevated blood glucose levels were also correlated with longer hospital lengths of stay in patients with mild and moderate TBI. Blood glucose levels did not significantly predict mortality in patients with severe TBI.

Elevated initial blood glucose levels were associated with poorer outcomes in patients with TBI, especially in those with moderate TBI. Further research, including larger multicenter studies, is needed to validate our findings and explore optimal glucose management strategies.