Persistent hyperglycemia is predictive of outcome in critically ill trauma patients

Grant V. Bochicchio, Jin Sung, Manjari Joshi, Kelly Bochicchio, Steven B. Johnson, Walter Meyer, Thomas M. Scalea

Research output: Contribution to journalArticle

Abstract

Objectives: Our objectives were to determine whether persistent hyperglycemia was predictive of outcome in critically ill trauma patients. Methods: Prospective data were collected daily on 942 consecutive trauma patients admitted to the ICU over a 2-year period. Patients were stratified by serum glucose level from day 1 to day 7 (low = 0-139 mg/dL, medium = 140-219 mg/dL, and high >220 mg/dL) age, gender, and ISS. Patients were further stratified by pattern of glucose control (all low, all moderate, all high, improving, worsening, highly variable (HV). Outcome was measured by ventilator days, infection, hospital (HLOS) and ICU (ILOS) length of stay and mortality. Multiple linear regression models were used to determine level of significance. Results: 71% were victims of blunt trauma. The majority (74%) were male with a mean ISS of 21.3 ± 15. 41% of patients acquired an infection. Patients with medium, high, worsening, and highly variable hyperglycemia were found to have increased ILOS, HLOS, ventilator days, infection rate and mortality by univariate analysis (p <0.01). When controlling for age, ISS, and glucose pattern, patients with high, worsening and HV hyperglycemia were most predictive of increased ventilator days, ILOS, HLOS, infection and mortality, (p <0.01). Conclusion: Trauma patients with persistent hyperglycemia have a significantly greater degree of morbidity and mortality. A prospective randomized controlled study instituting aggressive hyperglycemic control is warranted.

Original languageEnglish (US)
Pages (from-to)921-924
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume58
Issue number5
DOIs
StatePublished - May 2005
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Persistent hyperglycemia is predictive of outcome in critically ill trauma patients'. Together they form a unique fingerprint.

  • Cite this

    Bochicchio, G. V., Sung, J., Joshi, M., Bochicchio, K., Johnson, S. B., Meyer, W., & Scalea, T. M. (2005). Persistent hyperglycemia is predictive of outcome in critically ill trauma patients. Journal of Trauma - Injury, Infection and Critical Care, 58(5), 921-924. https://doi.org/10.1097/01.TA.0000162141.26392.07