Blood Glucose Levels and Outcome in Traumatic Brain Injury: An Observational Study

Background Traumatic brain injury (TBI) has been associated with an acute stress response mediated by the sympathoadrenomedullary axis, which can be assessed by measuring blood glucose level. Blood glucose can serve as a predictor of outcome in TBI Material and methods This prospective observational study was conducted between 1 june 2014 and 31 dec 2014.223 patients admitted for TBI in Neurosurgery department, of IMS, BHU were enrolled. Detailed history and data including blood glucose level and Glasgow Outcome Score at 3-month follow-up were taken and analysed. Results 223 patients were enrolled in the study but 4 died in the first 24 hrs and 3 were lost to follow up, hence were excluded.216 were included in study 62 females and 154 males. The majority of cases were young adult patients (mean age of 36.02 16.08 yrs). The mean glucose levels at admission in cases of mild TBI was 70.5 9.08 and 24 hrs after injury it was 82.94 18.3. In cases of moderate TBI the mean glucose values were 79.93 9.18 and 93.72 10.44 respectively. Severe TBI showed glucose at admission 105.67 23.81 and higher 24 hrs later, 128.02 23.99. Higher mean glucose level at admission and 24 hrs after injury was associated with a poor outcome in these patients with isolated TBI. Conclusion Mild, moderate, and severe TBI were associated with an increase in blood glucose levels during admission, and the mean increase in glucose levels wass based on the severity of the isolated TBI. Surgical intervention did not cause further significant changes in blood glucose levels. Patients with isolated TBI and minimal increases in blood glucose levels were more likely to have a favourable outcome.