The Relationship between Hyperglycemia and Neurologic, Functional Outcome with Traumatic Brain Injury

Choi, Seung Ho; Yoon, Joon Shik; Kim, Chang Hwan

Abstract

OBJECTIVE
Traumatic brain injury is related to the acute stress response, and this can be accompanied by an elevated serum glucose level. So we estimated the influence of hyperglycemia on neurologic, functional status and outcome. METHOD: We studied the 139 traumatic brain injured patients who had been admitted to the department of neurosurgery from 1996 to 2000, retrospectively. We reviewed initial serum glucose level, postoperative glucose level, and Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS). We compared these values with functional independence measure (FIM) scores. Patients were divided into two groups according to the initial serum glucose level, then we analyzed the correlation between glucose level and GCS, GOS, FIM.
RESULTS
The correlations of early hyperglycemia with GCS, GOS, initial FIM scores were significant (p<0.01). But serum glucose levels were not correlated with plateau FIM scores (p>0.05). Patients with unfavorable neurologic outcome after 10 days from head injury had significantly high serum initial and postoperative glucose levels than those with favorable neurologic outcome (p<0.01).
CONCLUSION
In patients who had received rehabilitation therapy with moderate or severe head injury, early hyperglycemia were significantly correlated with initial FIM scores, GCS, GOS, but not with the plateau FIM scores.