NEUROLOGY / RESEARCH PAPER
Postoperative hyperglycemia in patients with traumatic brain injury: what should we care
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1
Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, China
2
The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, 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
Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, China
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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 factor of hyperglycemia within 48 hours after 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 the age(r=0.415), BMI(r=0.441), diabetes(r=0.513), GCS score(r=0.545) and length of hospital stay(r=0.456) were all corrected to the postoperative hyperglycemia in TBI patients (all P<0.05). Age ≥ 60y (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 independently influencing factors of 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 patient with a total score ≥ 6, early interventions and care are needed to reduce the postoperative hyperglycemia.