Early hyperglycemic control is important in critically injured trauma patients

The Journal of Trauma
Grant V BochicchioThomas M Scalea

Abstract

Our objectives were to determine whether persistent hyperglycemia when compared with normoglycemia was predictive of outcome in the later stages of hospitalization in critically injured trauma patients. A prospective study was conducted on 896 consecutive trauma patients admitted to the intensive care unit during a 2-year period. Patients were stratified by serum glucose level on day 1 to day 28 (low = 0-139 mg/dL, medium to high = 140-219 mg/dL, and high = >220 mg/dL), age, gender, race, insulin dependent diabetes, obesity, and Injury Severity Score (ISS). Patients were further stratified by pattern of glucose control (all low, all moderate, all high, improving, worsening, highly variable. Outcome was measured by ventilator days, infection, hospital and intensive care unit length of stay, and mortality. Multiple variable logistic and linear regression models were used to determine level of significance. Eighty-three percent were victims of blunt trauma. The majority (74%) were male, with a mean ISS of 26 +/- 12. Hyperglycemia (moderate, worsening, and highly variable) in the first week was associated with significantly greater hospital and intensive care unit length of stay, ventilator time, infection, and mortality when contr...Continue Reading

References

Jul 1, 1987·Archives of Internal Medicine·B ChernowJ R Fletcher
Nov 1, 1994·Diabetes·G S Hotamisligil, B M Spiegelman
Feb 4, 1999·Critical Care Clinics·J Epstein, M J Breslow
Oct 6, 2001·Stroke; a Journal of Cerebral Circulation·S E CapesH C Gerstein
Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
Sep 11, 2002·Neurology·A BrunoUNKNOWN NINDS rt-PA Stroke Study Group
Jul 12, 2003·The Journal of Trauma·Saikrishna YendamuriGlen H Tinkoff
Jun 5, 2004·The Journal of Trauma·Amanda M LairdMichael C Chang
Aug 13, 2005·The Journal of Trauma·Jin SungThomas M Scalea

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Citations

Aug 10, 2010·Der Anaesthesist·V MannM Bernhard
Jan 7, 2011·Intensive Care Medicine·Iain M J MackenziePeter G Nightingale
Feb 5, 2010·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Ananda P Sen, Anil Gulati
Sep 21, 2012·The New England Journal of Medicine·Simon FinferBruce G Robinson
May 4, 2011·Journal of Neurotrauma·Syed Nabeel ZafarMarc A de Moya
Jan 14, 2011·Journal of Burn Care & Research : Official Publication of the American Burn Association·Chaitanya K DahagamCharles E Wade
Jun 18, 2009·Critical Care Medicine·Shyoko Honiden, Michelle N Gong
Mar 28, 2009·Critical Care Medicine·Brenda G FahyDouglas B Coursin
Jan 13, 2010·The Journal of Trauma·Bryan CollierAddison May
Dec 25, 2009·The Journal of Trauma·Ariane CoesterMaria Inês Schmidt
Nov 11, 2011·The Journal of Trauma·Matthew E KutcherMitchell Jay Cohen
Jul 26, 2013·Critical Care : the Official Journal of the Critical Care Forum·Lalantha LeelarathnaRoman Hovorka
May 26, 2012·Surgical Neurology International·Matthew C DavisAbdulrahman M El-Sayed
May 13, 2010·Acta neurochirurgica·José Roberto Tude MeloPhilippe Meyer
Jun 25, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jose Roberto Tude MeloMichel Zerah
Mar 10, 2016·Journal of Research in Medical Sciences : the Official Journal of Isfahan University of Medical Sciences·Berna TerziogluZafer Berkman
Dec 26, 2015·World Neurosurgery·Firooz SalehpourSeyed Ahmad Naseri Alavi
Oct 12, 2014·Advanced Drug Delivery Reviews·Xin LiuMichael S Roberts
Sep 4, 2012·Surgery·Theresa L ChinAnirban Banerjee
Jul 9, 2010·Journal of the American College of Surgeons·Pablo E SerranoJohn J Fath
Oct 29, 2008·Advances in Surgery·Grant V Bochicchio, Thomas M Scalea
Aug 14, 2009·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·S-A LiuY-T Chiu
Jul 9, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Eric J MorleyRichard Sinert
Jun 6, 2013·Japan Journal of Nursing Science : JJNS·Hyun Soo Oh, Wha Sook Seo
Nov 13, 2012·The Journal of Arthroplasty·Lazaros A PoultsidesStavros G Memtsoudis
Jan 24, 2015·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Kathryn Moore
Jul 11, 2016·Contemporary Clinical Trials·Eden NohraGrant V Bochicchio
Jun 3, 2015·Journal of Diabetes Science and Technology·Grant V BochicchioJeffrey I Joseph
Aug 24, 2012·JPEN. Journal of Parenteral and Enteral Nutrition·Roland N DickersonRex O Brown
Feb 11, 2010·Journal of Diabetes Science and Technology·James Eakins
Feb 11, 2010·Journal of Diabetes Science and Technology·Peggy Magarian, Bernhard Sterling
Oct 20, 2009·Arquivos de neuro-psiquiatria·José Roberto Tude MeloJamary Oliveira-Filho
Mar 23, 2017·The Journal of Trauma and Acute Care Surgery·Grant V BochicchioKelly Bochicchio
Apr 7, 2018·PloS One·Elena OlariuJean-Charles Preiser
Aug 15, 2018·The Journal of Bone and Joint Surgery. American Volume·Michael M KheirAntonia F Chen
May 21, 2009·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Etie S MoghissiUNKNOWN American Diabetes Association
Jun 20, 2012·The Journal of Trauma and Acute Care Surgery·Riad Cachecho, Eric Dobkin
Dec 18, 2013·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Cassiana Regina GóesDaniela Ponce

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