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NEUROLOGY / CLINICAL RESEARCH
Postoperative hyperglycemia in patients with traumatic brain injury: development of a prediction model
1
Department of Neurosurgery, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
2
Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support Force of Chinese People’s Liberation Army, Wuxi, China
These authors had equal contribution to this work
Submission date: 2024-02-21
Final revision date: 2024-04-16
Acceptance date: 2024-04-27
Online publication date: 2024-06-06
Corresponding author
Xianlan Meng
Department of Neurosurgery, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
Department of Neurosurgery, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Blood glucose monitoring and management are very important for the prognosis of patients with traumatic brain injury (TBI). It is necessary to evaluate the status and influencing factors of hyperglycemia within 48 h after the operation in patients with TBI.
Material and methods:
Patients with TBI who received craniocerebral surgery between March 1, 2022, and October 31, 2023, were enrolled. We assessed the clinical characteristics of TBI patients with and without the development of postoperative hyperglycemia. To identify potential risk factors associated with postoperative hyperglycemia, we performed both univariate and multivariate logistic regression analyses. Utilizing the regression coefficients derived from each significant risk factor, we subsequently constructed a predictive model aimed at forecasting postoperative hyperglycemia.
Results:
A total of 216 TBI patients were included. The incidence of postoperative hyperglycemia was 31.48%. Correlation analysis indicated that age (r = 0.415), body mass index (BMI) (r = 0.441), diabetes (r = 0.513), Glasgow Coma Scale (GCS) score (r = 0.545) and length of hospital stay (r = 0.456) were all correlated with the postoperative hyperglycemia in TBI patients (all p < 0.05). Age ≥ 60 years (OR = 2.556, 95% CI: 1.831–3.641), BMI ≥ 24 kg/m2 (OR = 2.793, 95% CI: 2.305–3.679), diabetes (OR = 3.081, 95% CI: 2.326–3.811) and GCS score ≤ 8 (OR = 3.603, 95% CI: 1.956–4.086) were the independent factors influencing postoperative hyperglycemia in TBI patients (all p < 0.05). The area under the receiver operating characteristic curve and 95% CI were 0.795 (0.712, 0.849). The model had good discriminative ability to distinguish the occurrence of postoperative hyperglycemia in TBI patients (all p < 0.05).
Conclusions:
Postoperative hyperglycemia in patients with TBI is common. For TBI patients with a total score ≥ 6 in the prediction model, early interventions and care are needed to reduce the postoperative hyperglycemia.
Blood glucose monitoring and management are very important for the prognosis of patients with traumatic brain injury (TBI). It is necessary to evaluate the status and influencing factors of hyperglycemia within 48 h after the operation in patients with TBI.
Material and methods:
Patients with TBI who received craniocerebral surgery between March 1, 2022, and October 31, 2023, were enrolled. We assessed the clinical characteristics of TBI patients with and without the development of postoperative hyperglycemia. To identify potential risk factors associated with postoperative hyperglycemia, we performed both univariate and multivariate logistic regression analyses. Utilizing the regression coefficients derived from each significant risk factor, we subsequently constructed a predictive model aimed at forecasting postoperative hyperglycemia.
Results:
A total of 216 TBI patients were included. The incidence of postoperative hyperglycemia was 31.48%. Correlation analysis indicated that age (r = 0.415), body mass index (BMI) (r = 0.441), diabetes (r = 0.513), Glasgow Coma Scale (GCS) score (r = 0.545) and length of hospital stay (r = 0.456) were all correlated with the postoperative hyperglycemia in TBI patients (all p < 0.05). Age ≥ 60 years (OR = 2.556, 95% CI: 1.831–3.641), BMI ≥ 24 kg/m2 (OR = 2.793, 95% CI: 2.305–3.679), diabetes (OR = 3.081, 95% CI: 2.326–3.811) and GCS score ≤ 8 (OR = 3.603, 95% CI: 1.956–4.086) were the independent factors influencing postoperative hyperglycemia in TBI patients (all p < 0.05). The area under the receiver operating characteristic curve and 95% CI were 0.795 (0.712, 0.849). The model had good discriminative ability to distinguish the occurrence of postoperative hyperglycemia in TBI patients (all p < 0.05).
Conclusions:
Postoperative hyperglycemia in patients with TBI is common. For TBI patients with a total score ≥ 6 in the prediction model, early interventions and care are needed to reduce the postoperative hyperglycemia.
REFERENCES (52)
1.
Jiang H, Yang F, Cao Y, et al. Epidemiological characteristics of traumatic brain injury in the first affiliated Hospital of Kunming Medical University from 2004 to 2013. J Kunming Med Univ 2022; 43: 12-8.
2.
Zhu N, Su R, Zhou J. Research progress of spontaneous hyperventilation in patients with severe traumatic craniocerebral injury. Chin Electron J Crit Care Med 2021; 7: 5-8.
3.
Li D, Wang Y. Clinical diagnosis and treatment of traumatic brain injury. Chin Med 2023; 28: 6-9.
4.
Davidson MB. Historical review of the diagnosis of prediabetes/intermediate hyperglycemia: case for the international criteria. Diabetes Res Clin Pract 2022; 185: 109219.
5.
Marini JI, Sein ME. The role of the glucose potassium ratio in the management of traumatic brain injury. Korean J Neurotrauma 2023; 19: 82-9.
6.
Banoei MM, Lee CH, Hutchison J, et al.; Canadian biobank dfTBIitCCCTBGtCTBIRCN. Using metabolomics to predict severe traumatic brain injury outcome (GOSE) at 3 and 12 months. Crit Care 2023; 27: 295.
7.
Huang Q, Huang X, Zhang Q. Clinical significance of monitoring blood glucose and serum adiponectin after traumatic brain injury in children. Shandong Med Coll J 2021; 36: 11-4.
8.
Wu S, Zeng G. Effect of intensive insulin therapy on blood glucose control in diabetic patients with craniocerebral trauma. N World Diab 2021; 24: 89-92.
9.
Akerlund CAI, Holst A, Bhattacharyay S, et al., CENTER-TBI participants and investigators. Clinical descriptors of disease trajectories in patients with traumatic brain injury in the intensive care unit (CENTER-TBI): a multicentre observational cohort study. Lancet Neurol 2024; 23: 71-80.
10.
Torabi M, Amiri ZS, Mirzaee M. Blood glucose level as a predictor of abnormal brain computed tomography scan findings in patients with mild traumatic brain injury. Bull Emerg Trauma 2023; 11: 83-9.
11.
Zhou H, Tang Y, Li Y, Zhu T. Serum glucose-potassium ratio predicts prognosis of traumatic brain injury in patients undergoing emergency craniotomy: a retrospective study. Asian J Surg 2023; 46: 2958-9.
12.
Cummins TL, Dore V, Feizpour A, et al. Tau, beta-amyloid, and glucose metabolism following service-related traumatic brain injury in vietnam war veterans: the Australian Imaging Biomarkers and Lifestyle Study of Aging-Veterans Study (AIBL-VETS). J Neurotrauma 2023; 40: 1086-97.
13.
Wu X, Lin Y, Huang W. Double C therapy alleviates the correlation between blood glucose fluctuation and prognosis in patients with severe craniocerebral injury. China Health Stand Manag 2021; 28: 10-2.
14.
Hu Q. Relationship between blood glucose, glycosylated hemoglobin and acute renal injury in patients with traumatic brain injury. Chin J Health Inspect 2022; 26: 5-9.
15.
Ismail AMA, Abdelghany A, Atef H. Response of testosterone and semen parameters to a 14-week aerobic training in sedentary obese men with hyperglycaemia. Physiother Quart 2023; 31: 28-33.
16.
Ali Ismail AM, Abd El-Azeim AS. Immediate fasting blood glucose response to electroacupuncture of ST36 versus CV12 in patients with type 2 diabetes mellitus: randomized controlled trial. Fam Med Prim Care Rev 2021; 23: 437-41.
17.
Cleri NA, Saadon JR, Zheng X, et al. Predicting traumatic brain injury outcomes using a posterior dominant rhythm. J Neurosurg 2023; 139: 1523-33.
18.
Fenger AW, Olsen MH, Fabritius ML, Riberholt CG, Moller K. Glycaemic control for patients with severe acute brain injury: protocol for a systematic review. Acta Anaesthesiol Scand 2023; 67: 240-7.
19.
Zhang Q, Li X. Application of refined enteral nutrition and blood glucose management in patients with severe craniocerebral injury complicated with stress hyperglycemia. Nurs Res 2021; 35: 5-7.
20.
Fan S, Bo F. Clinical comparison of MRI and CT in the diagnosis of acute craniocerebral injury. China J Health Nutr 2013; 23: 313-6.
21.
Ma H, Huang Y. Nursing research progress of stress hyperglycemia in critically ill patients. Shanghai Nurs 2023; 23: 25-9.
22.
Mayer AR, Dodd AB, Dodd RJ, et al. Head kinematics, blood biomarkers, and histology in large animal models of traumatic brain injury and hemorrhagic shock. J Neurotrauma 2023; 40: 2205-16.
23.
Ismail AMA, El-Azeim ASA. Response of erectile dysfunction to extracorporeal shock wave therapy in type 2 diabetic men. Physiother Quart 2022; 30: 77-80.
24.
Ismail AMA, Tolba AMN, Felaya ESEES. Effect of aerobic exercise training on leptin and liver enzymes in non-diabetic overweight hepatitis C men. Adv Rehab 2021; 35: 17-23.
25.
Lu Z, Tao G, Sun X, et al. Association of blood glucose level and glycemic variability with mortality in sepsis patients during ICU hospitalization. Front Public Health 2022; 10: 857368.
26.
Honiden S, Inzucchi SE. Metabolic management during critical illness: glycemic control in the ICU. Semin Respir Crit Care Med 2015; 36: 859-69.
27.
Mirzaei F, Khodadadi I, Vafaei SA, Abbasi-Oshaghi E, Tayebinia H, Farahani F. Importance of hyperglycemia in COVID-19 intensive-care patients: mechanism and treatment strategy. Prim Care Diabetes 2021; 15: 409-16.
28.
Dong Y, Huang Z. Effect of stress hyperglycemia on cognitive impairment in patients with moderate traumatic craniocerebral injury. J Pract Cardiac Cerebropulmon Vasc Dis 2023; 31: 5-7.
29.
Bogossian EG, Taleb C, Aspide R, et al. Cerebro-spinal fluid glucose and lactate concentrations changes in response to therapies in patIents with primary brain injury: the START-TRIP study. Crit Care 2023; 27: 130.
30.
Rezakhah A, Kobets AJ, Emami Sigaroudi F, et al. Correlation between clinical findings at admission and Glasgow outcome scale score in children with traumatic brain injury. World Neurosurg 2023; 175: e1300-6.
31.
Du M, Zhang QH, Tang R, et al. Prognostic significance of plasma insulin level for deep venous thrombosis in patients with severe traumatic brain injury in critical care. Neurocrit Care 2023; 38: 263-78.
32.
Yao S, Chong SL, Allen JC, et al. Early metabolic derangements and unfavorable outcomes in pediatric traumatic brain injury: a retrospective multi-center cohort study. Transl Pediatr 2023; 12: 344-53.
33.
Wilson LD, Maiga AW, Lombardo S, et al. Dynamic predictors of in-hospital and 3-year mortality after traumatic brain injury: a retrospective cohort study. Am J Surg 2023; 225: 781-6.
34.
Huang L, Luo Z, Chen Y. Dynamic monitoring of blood glucose and effect of nursing intervention in patients with severe craniocerebral injury and hyperglycemia. Contemp Nurses 2011; 16: 2-5.
35.
Lai JQ, Shi YC, Lin S, Chen XR. Metabolic disorders on cognitive dysfunction after traumatic brain injury. Trends Endocrinol Metab 2022; 33: 451-62.
36.
Hu T, Han Z, Xiong X, et al: Inhibition of exosome release alleviates cognitive impairment after repetitive mild traumatic brain injury. Front Cell Neurosci 2022; 16: 832140.
37.
Huang P. Research progress of postoperative blood glucose management in non-diabetic patients. Chin J Clin 2013; 7: 3-6.
38.
Demers-Marcil S, Coles JP. Cerebral metabolic derangements following traumatic brain injury. Curr Opin.
40.
He H. Effect of nursing intervention on prognosis of severe craniocerebral injury patients with stress hyperglycemia. China Med Guide 2011; 16: 162-3.
41.
Yuan T, He H, Liu Y, et al. Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial. Trials 2022; 23: 38.
42.
de Oliveira DV, Vieira RCA, Pipek LZ, et al. Long-term outcomes in severe traumatic brain injury and associated factors: a prospective cohort study. J Clin Med 2022; 11: 6466.
43.
Cui L, Liu L, Wang J, et al. The best evidence of perioperative blood glucose management in patients undergoing pancreatectomy. Chin General Med 2022; 25: 1047-53.
44.
Luo Q, Li L, Meng X. Monitoring and nursing of intensive insulin therapy in patients with severe craniocerebral injury complicated with stress hyperglycemia. Chin J Pract Neurol 2012; 31: 15-7.
45.
Nie F, Fan Y, Ding D. Application of multidisciplinary blood glucose management program in patients with craniocerebral injury and stress hyperglycemia. J Neurol 2023; 30: 106-7.
46.
Chen D, Huang J, Jin Y. Clinical and imaging analysis of 3 patients with hyperglycemia-related acute brain injury. Chin J Pract Neurol 2023; 26: 1162-8.
47.
Zhang Q, Li X. Application of refined enteral nutrition and blood glucose management in patients with severe craniocerebral injury complicated with stress hyperglycemia. Nurs Res 2021; 35: 5 -7.
48.
LV J, Ji Y. Nursing analysis of a postoperative craniocerebral trauma patient with stress hyperglycemia. Med Health 2022; 36: 4-7.
49.
Huang L, Luo Z, Chen Y. Dynamic monitoring of blood glucose and effect of nursing intervention in patients with severe craniocerebral injury and hyperglycemia. Contemp Nurses 2011; 35: 2-4.
50.
Xiang J, Yang X, Gong J. Clinical significance of dynamic blood glucose monitoring in patients with severe craniocerebral injury. Chin J Integr Tradit Western Med 2014; 21: 4-7.
51.
Cao C, Wang H, Gao H, Wu W. Insulin resistance is associated with an unfavorable outcome among non-diabetic patients with isolated moderate-to-severe traumatic brain injury – a propensity score-matched study. Front Neurol 2022; 13: 949091.
52.
Korkmaz N, Kesikburun S, Atar MO, Sabuncu T. Insulin resistance and related factors in patients with moderate and severe traumatic brain injury. Ir J Med Sci 2023; 192: 1177-82.
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