Format

Send to

Choose Destination
J Trauma. 2008 May;64(5):1184-7. doi: 10.1097/TA.0b013e31816c5c95.

Blood glucose levels at 24 hours after trauma fails to predict outcomes.

Author information

1
Division of Trauma Critical Care and Emergency General Surgery, Virginia Commonwealth University Medical Center, Virginia, USA. tmduane@vcu.edu

Abstract

BACKGROUND:

Blood glucose (BG) at admission correlates with lactate and outcomes. The purpose of this study was to determine whether this correlation continues at 24 hours.

METHODS:

We studied 335 trauma patients correlating Injury Severity Score (ISS), lactate, and outcome parameters to BG at admission and 24 hours.

RESULTS:

There were 134 patients at admission and 68 patients at 24 hours who had a high blood glucose (HBG) (>150 mg/dL). Admission HBG group had higher ISS (25.3 +/- 13.6 vs. 19.8 +/- 11.4, p = 0.0002, analysis of covariance p < 0.0001), longer lengths of stays (in days) (ventilator: 2.0 +/- 4.4 high blood sugar [HBS] vs. 0.8 +/- 2.5 low blood sugar [LBS], p = 0.0034; intensive care unit: 7.7 +/- 10.1 HBS vs. 4.6 +/- 7.5 LBS, p = 0.0001; hospital: 14.7 +/- 13.8 HBS vs. 9.8 +/- 11.6 LBS, p < 0.0001) and a higher mortality rate (15.67% [21 of 134] HBS vs. 7.46% [15 of 201] LBS, p = 0.02) compared with the LBS group. A significant linear relationship existed between ISS and blood sugar (r = 0.06, p < 0.0001) and ISS and lactate (r = 0.05, p < 0.0001). The Pearson correlation identified that blood sugar and lactate trended together (r = 0.3, p < 0.0001). Twenty-four-hour HBG failed to correlate with worse outcomes. With lactate </=2.2 mmol/L at 24 hours (n = 287), there was no difference in mortality between the HBG and LBG groups (9.8% [5 of 51] HBS vs. 6.36% [15 of 236] LBS, p = 0.37). In the LBG group at 24 hours (n = 267), there was a significant difference in mortality with a lactate >2.2 mmol/L group (35.5% [11 of 31] vs. 6.36% [15 of 236], p = 0.00003). Using logistic regression, only lactate at 24 hours (odds ratio 1.79, 95% confidence interval 1.259-2.546) and ISS (odds ratio 1.1, 95% confidence interval 1.06-1.15) were independently predictive of death.

CONCLUSIONS:

BG levels at 24 hours do not correlate with outcome, particularly if the patient is adequately resuscitated with a normal lactate.

PMID:
18469639
DOI:
10.1097/TA.0b013e31816c5c95
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center