Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay
We aim to study the association between hyperglycemia and in-hospital outcomes among children with moderate and severe traumatic brain injury (TBI). This retrospective cohort study was conducted in a tertiary pediatric hospital between 2003 and 2013. All patients < 16 years old who presented to t...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/719476 |
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| author | Shu-Ling Chong Sumitro Harjanto Daniela Testoni Zhi Min Ng Chyi Yeu David Low Khai Pin Lee Jan Hau Lee |
| author_facet | Shu-Ling Chong Sumitro Harjanto Daniela Testoni Zhi Min Ng Chyi Yeu David Low Khai Pin Lee Jan Hau Lee |
| author_sort | Shu-Ling Chong |
| collection | DOAJ |
| description | We aim to study the association between hyperglycemia and in-hospital outcomes among children with moderate and severe traumatic brain injury (TBI). This retrospective cohort study was conducted in a tertiary pediatric hospital between 2003 and 2013. All patients < 16 years old who presented to the Emergency Department within 24 hours of head injury with a Glasgow Coma Scale (GCS) ≤ 13 were included. Our outcomes of interest were death, 14 ventilation-free, 14 pediatric intensive care unit- (PICU-) free, and 28 hospital-free days. Hyperglycemia was defined as glucose > 200 mg/dL (11.1 mmol/L). Among the 44 patients analyzed, the median age was 8.6 years (interquartile range (IQR) 5.0–11.0). Median GCS and pediatric trauma scores were 7 (IQR 4–10) and 4 (IQR 3–6), respectively. Initial hyperglycemia was associated with death (37% in the hyperglycemia group versus 8% in the normoglycemia group, p=0.019), reduced median PICU-free days (6 days versus 11 days, p=0.006), and reduced median ventilation-free days (8 days versus 12 days, p=0.008). This association was however not significant in the stratified analysis of patients with GCS ≤ 8. Conclusion. Our findings demonstrate that early hyperglycemia is associated with increased mortality, prolonged duration of mechanical ventilation, and PICU stay in children with TBI. |
| format | Article |
| id | doaj-art-c6091e2fd98748ed942fdf8cf789dae3 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-c6091e2fd98748ed942fdf8cf789dae32025-02-03T05:45:16ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/719476719476Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care StayShu-Ling Chong0Sumitro Harjanto1Daniela Testoni2Zhi Min Ng3Chyi Yeu David Low4Khai Pin Lee5Jan Hau Lee6Department of Emergency Medicine, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, 229899, SingaporeDuke-NUS Graduate Medical School, 8 College Road, 169857, SingaporeDivision of Neonatal Medicine, Escola Paulista de Medicina-Universidade Federal de Sao Paulo, Rua Marselhesa 630, Vila Clementino, 04020-060 São Paulo, SP, BrazilSingHealth Duke-NUS Paediatrics Academic Clinical Programme, 100 Bukit Timah Road, 229899, SingaporeDepartment of Neurosurgery, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, 229899, SingaporeDepartment of Emergency Medicine, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, 229899, SingaporeSingHealth Duke-NUS Paediatrics Academic Clinical Programme, 100 Bukit Timah Road, 229899, SingaporeWe aim to study the association between hyperglycemia and in-hospital outcomes among children with moderate and severe traumatic brain injury (TBI). This retrospective cohort study was conducted in a tertiary pediatric hospital between 2003 and 2013. All patients < 16 years old who presented to the Emergency Department within 24 hours of head injury with a Glasgow Coma Scale (GCS) ≤ 13 were included. Our outcomes of interest were death, 14 ventilation-free, 14 pediatric intensive care unit- (PICU-) free, and 28 hospital-free days. Hyperglycemia was defined as glucose > 200 mg/dL (11.1 mmol/L). Among the 44 patients analyzed, the median age was 8.6 years (interquartile range (IQR) 5.0–11.0). Median GCS and pediatric trauma scores were 7 (IQR 4–10) and 4 (IQR 3–6), respectively. Initial hyperglycemia was associated with death (37% in the hyperglycemia group versus 8% in the normoglycemia group, p=0.019), reduced median PICU-free days (6 days versus 11 days, p=0.006), and reduced median ventilation-free days (8 days versus 12 days, p=0.008). This association was however not significant in the stratified analysis of patients with GCS ≤ 8. Conclusion. Our findings demonstrate that early hyperglycemia is associated with increased mortality, prolonged duration of mechanical ventilation, and PICU stay in children with TBI.http://dx.doi.org/10.1155/2015/719476 |
| spellingShingle | Shu-Ling Chong Sumitro Harjanto Daniela Testoni Zhi Min Ng Chyi Yeu David Low Khai Pin Lee Jan Hau Lee Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay International Journal of Endocrinology |
| title | Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay |
| title_full | Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay |
| title_fullStr | Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay |
| title_full_unstemmed | Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay |
| title_short | Early Hyperglycemia in Pediatric Traumatic Brain Injury Predicts for Mortality, Prolonged Duration of Mechanical Ventilation, and Intensive Care Stay |
| title_sort | early hyperglycemia in pediatric traumatic brain injury predicts for mortality prolonged duration of mechanical ventilation and intensive care stay |
| url | http://dx.doi.org/10.1155/2015/719476 |
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