The effect of blood glucose levels on the prognosis of acute severe traumatic brain injury patients
10.3760/cma.j.issn.1674-6090.2018.04.013
- VernacularTitle:急性重型颅脑损伤患者血糖水平对预后的影响
- Author:
Caikui LUO
1
;
Liang MENG
;
Yuefei WANG
;
Xiaoxiang YU
Author Information
1. 430073,武汉大学附属同仁医院(武汉市第三医院)神经外科
- Keywords:
Blood glucose level;
Acute severe craniocerebral injury;
Hyperglycemia;
Prognosis
- From:
Chinese Journal of Endocrine Surgery
2018;12(4):318-321
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between different blood glucose levels and prognosis in patients with acute severe craniocerebral injury.Methods Clinical data of 120 patients with acute severe craniocerebral injury from Jun.2014 to Jun.2017 in Department of Neurosurgery,Tongren Hospital of Wuhan University were analyzed retrospectively.The patients were divided into the group of acute severe craniocerebral injury and the group of acute extra-severe craniocerebral injury according to the Glasgow coma score (GCS).Blood glucose levels were detected at the time of admission,the 1st day,the 3rd day,the 7th day and the 14th day after operation.According to the blood glucose levels on admission,the patients were divided into the normal blood glucose group,the blood glucose value of 6.1-10.0 mmol/L group,the blood glucose value ＞ 10.0 mmol/L group.The prognosis was evaluated by Glasgow Outcome Score (GOS) 3 months after discharge.The relationship between the blood glucose levels and GOS score in different groups was analyzed.Results The blood glucose levels in the group of acute extra-severe craniocerebral injury were higher than those in the group of acute severe craniocerebral injury,and the difference was statistically significant (P＜0.05).Of the patients with acute severe craniocerebral injury,54 had good prognosis,and 16 had poor prognosis.Of the patients with acute extra-severe craniocerebral injury,28 had good prognosis,and 22 had poor prognosis.The rate of good prognosis were 77.1％ and 56％ respectively,and the difference had statistical significance (P=0.014,x2=6.025).The good prognosis of patients with normal blood glucose group was 23 and the poor prognosis was 4,with a good prognosis rate of 85.2％ (23/27).Among patients with blood glucose of 6.1-10.0 mmol/L,30 had good prognosis and 8 had poor prognosis,with a good prognosis rate of 78.9％(30/38).Among patients with blood glucose ＞10.0 mmol/L,31 had good prognosis and 24 had poor prognosis,with a good prognosis rate of 56.4％ (31/55).With the increase of blood glucose,the good prognosis rate gradually decreased and the poor prognosis rate gradually increased,and the difference was statistically significant(P=0.010,x2=9.283).Conclusion Blood glucose level has influence on the prognosis of patients with acute severe craniocerebral injury,and the good prognosis of patients with acute severe craniocerebral injury is severely affected by hyperglycemia.
