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Hyperglycemia and Outcomes after Acute Traumatic Spinal Cord Injury: Scoping Review
Michael Coffin1, Kyle McGrath1, Rebecca Garner1
1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Neurotrauma Reports
|August 1, 2026
Summary
Early hyperglycemia in traumatic spinal cord injury (TSCI) is linked to worse outcomes, but evidence is limited. More research is needed to confirm glucose as a prognostic biomarker for TSCI patients.
Area of Science:
- Neurocritical care
- Traumatology
- Endocrinology
Background:
- Hyperglycemia is a known prognostic marker in neurocritical care.
- Specific data and glycemic targets for traumatic spinal cord injury (TSCI) are lacking.
Purpose of the Study:
- To review how early hyperglycemia is defined and measured in acute TSCI.
- To examine the relationship between hyperglycemia and neurological/functional outcomes in TSCI.
Main Methods:
- Scoping review of PubMed, Embase, and Scopus (inception to Nov 2025).
- Included observational studies of adults (≥18) within 7 days of TSCI, defining hyperglycemia at ≥126 mg/dL.
- Excluded pediatric, diabetes-only, non-traumatic, animal, and chronic-phase studies.
Main Results:
- 6 observational studies (n=2586) met criteria, mostly cervical injuries.
- Higher admission glucose associated with severe impairment; hyperglycemia linked to poorer motor recovery and outcomes.
- Associations often attenuated after multivariable adjustment.
Conclusions:
- Evidence on hyperglycemia in acute TSCI is limited, heterogeneous, and observational.
- Early hyperglycemia shows potential prognostic value but lacks consistent effect estimates for specific targets.
- Glucose requires validation as a prognostic biomarker in prospective TSCI cohorts.
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