Hyperglycemia and outcomes from pediatric traumatic brain injury
Hyperglycemia and outcomes from pediatric traumatic brain injury
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DOI：
10.1097/01.ta.0000031175.96507.48
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发表时间：
2003-12-01
影响因子：
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通讯作者：
Downey, EC
中科院分区：
文献类型：
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作者：
Cochran, A;Scaife, ER;Downey, EC
背景儿童创伤性脑损伤后高血糖的临床意义存在争议。本研究旨在探讨小儿创伤性脑损伤后高血糖与预后的关系。我们确定了在一年内被我们的地区儿科转诊中心收治的头部地区简明损伤量表评分大于或等于3分的创伤患者。我们研究了确定的患者的入院特征可能影响他们的结果。主要的结局指标是格拉斯哥结局量表评分。死亡患者的入院血清葡萄糖值显著高于存活患者（267 mg/dL vs. 135 mg/dL; p = 0.000）。入院时血糖大于或等于300 mg/dL与死亡一致相关。入院格拉斯哥昏迷评分（比值比，0.560; 95%可信区间，0.358-0.877）和血糖（比值比，1.013; 95%可信区间，1.003-1.023）是儿童颅脑损伤死亡率的独立预测因子。脑损伤儿童的高血压和神经功能不良的结果是相关的。脑外伤后神经系统损伤中高血糖的病理生理机制尚不清楚。
Background. The clinical significance of hyperglycemia after pediatric traumatic brain injury is controversial. This study addresses the relationship between hyperglycemia and outcomes after traumatic brain injury in pediatric patients.Method. We identified trauma patients admitted during a single year to our regional pediatric referral center with head regional Abbreviated Injury Scale scores greater than or equal to 3. We studied identified patients for admission characteristics potentially influencing their outcomes. The primary outcome measure was Glasgow Outcome Scale score.Results. Patients who died had significantly higher admission serum glucose values than those patients who survived (267 mg/dL vs. 135 mg/dL; p = 0.000). Admission serum glucose greater than or equal to 300 mg/dL was uniformly associated with death. Admission Glasgow Coma Scale score (odds ratio, 0.560; 95% confidence interval, 0.358-0.877) and serum glucose (odds ratio, 1.013; 95% confidence interval, 1.003-1.023) are independent predictors of mortality in children with traumatic head injuries.Conclusion. Hyperglycemia and poor neurologic outcome in head-injured children are associated. The pathophysiology of hyperglycemia in neurologic injury after head trauma remains unclear.