Blood Glucose Levels in Traumatic Injury Patients: An Observational Study
Journal name: The Malaysian Journal of Medical Sciences
Original article title: An Observational Study of Blood Glucose Levels during Admission and 24 Hours Post-Operation in a Sample of Patients with Traumatic Injury in a Hospital in Kuala Lumpur
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Rahmat Harun @ Haron, Musa Kamarul Imran, Mohammed Saffari Mohammed Haspani
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: An Observational Study of Blood Glucose Levels during Admission and 24 Hours Post-Operation in a Sample of Patients with Traumatic Injury in a Hospital in Kuala Lumpur
Year: 2011
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Traumatic brain injury (TBI) triggers an acute stress response, often resulting in hyperglycemia, which has been shown to negatively impact neurological outcomes. A prospective observational study conducted at Hospital Kuala Lumpur in 2007 involved 294 patients treated for TBI. The study aimed to correlate blood glucose levels with the severity of TBI and subsequent patient outcomes measured by the Glasgow Outcome Score three months post-injury.
Hyperglycemia as a Prognostic Indicator
One of the primary findings of the study is the significant correlation between blood glucose levels and the severity of TBI. Patients with mild, moderate, and severe TBI demonstrated increasing admission glucose levels, with means of 5.04 mmol/L, 5.78 mmol/L, and 7.04 mmol/L respectively. Notably, higher admission glucose levels were associated with poorer outcomes, particularly in patients with isolated TBI. Patients with lower admission glucose levels (below 6.0 mmol/L) had better recovery outcomes compared to those with levels above 7.9 mmol/L. This suggests that hyperglycemia is a vital independent predictor of outcomes in TBI patients, underscoring its importance as a potential target for therapeutic intervention.
Conclusion
The study highlights the relevance of monitoring blood glucose levels in TBI patients as a means to assess stress response and predict outcomes. Surgical interventions did not significantly alter glucose levels, indicating that the isolated impact of TBI alone can cause elevated blood glucose. The findings advocate for potential future research into tight glycemic control as a strategy to improve patient outcomes following TBI. By emphasizing the critical nature of hyperglycemia, the results contribute to better understanding and management of TBI in clinical settings.
FAQ section (important questions/answers):
What is the relationship between blood glucose levels and TBI severity?
Higher blood glucose levels were found to be associated with increased severity of traumatic brain injury (TBI). Specifically, severe TBI patients had significantly higher glucose levels compared to those with moderate and mild TBI.
How does surgical intervention affect blood glucose levels in TBI patients?
Surgical intervention did not cause significant changes in blood glucose levels. The study suggested that elevated glucose levels are primarily a result of the isolated TBI itself rather than the surgical process.
What outcomes are associated with different blood glucose levels in TBI patients?
Patients with lower admission blood glucose levels (below 6.0 mmol/L) typically had better outcomes. Conversely, higher levels (above 7.9 mmol/L) were associated with poorer prognoses, indicating blood glucose could be a predictor of recovery.
What demographic patterns were observed among TBI patients in the study?
The majority of patients were young adults, with a mean age of 34.2 years. Most patients were male, constituting 83% of the sample, and traffic accidents were the most common cause of TBI.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Blood Glucose Levels in Traumatic Injury Patients: An Observational Study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Blood:
In the context of traumatic brain injury (TBI), blood refers to the circulatory fluid that is crucial for delivering oxygen and nutrients to the brain. The study highlighted the link between blood glucose levels and the severity of TBI, emphasizing how elevated blood glucose (hyperglycemia) can indicate stress response and correlate with outcomes.
2) Study (Studying):
The study refers to the observational and prospective research conducted among patients with traumatic brain injury at Hospital Kuala Lumpur. It aimed to explore the relationship between admission blood glucose levels and the outcomes of TBI. This research adds to existing knowledge regarding the biochemical responses to head trauma.
3) Post:
Post typically refers to the period following an event or intervention. In this study, post-surgery blood glucose levels were measured 24 hours after surgical intervention. This allows for an evaluation of how surgical treatment may impact physiological responses, such as blood glucose, in patients recovering from TBI.
4) Male:
In the study, male patients constituted a significant majority (83%) of the trauma cases. Gender was explored as a demographic variable, as research indicates potential differences in TBI outcomes based on gender. Understanding gender distribution helps contextualize the data and tailor interventions for at-risk populations.
5) Table:
The term 'table' refers to the organized data representation in the study. It presents demographic, clinical data, and the results related to blood glucose levels and outcomes based on the severity of TBI. Tables are essential for visualizing complex data, aiding in analysis and interpretation.
6) Discussion:
Discussion in the study refers to the section where authors interpret findings, relate them to previous research, and explore implications. It critiques the outcomes, outlines limitations, and suggests potential clinical applications based on blood glucose levels, enhancing understanding of factors influencing TBI recovery.
7) Animal:
Animal refers to the studies conducted on animal models to evaluate the effects of traumatic brain injury and hyperglycemia. Research involving animals provides insights into physiological responses, such as hormonal and metabolic changes, and helps to establish potential mechanisms affecting outcomes, guiding human clinical research.
8) Coma:
Coma is a state of prolonged unconsciousness often resulting from severe brain injury. The study uses the Glasgow Coma Scale (GCS) to categorize patient severity. Coma status is critically linked to prognosis; understanding its association with blood glucose levels is vital for predicting outcomes after TBI.
9) Accumulation (Accumulating, Accumulate):
Accumulation in this context refers to the buildup of inflammatory cells or metabolites, such as neutrophils, following brain injury. Increased accumulation can exacerbate injury, indicating a need for tighter control of metabolic responses like blood glucose levels in TBI patients to mitigate secondary damage.
10) Sugar:
Sugar refers to glucose, a key energy source for the body and its relevance in TBI was highlighted through blood glucose measurements. Elevated blood sugar levels can be indicative of stress responses post-injury, and understanding these patterns helps in managing TBI recovery and predicting outcomes.
11) Pur:
Poor refers to suboptimal outcomes in patients following traumatic brain injury. The study found that higher admission blood glucose levels were associated with poorer recovery and increased mortality risk. Identifying factors that lead to poorer outcomes is essential for enhancing treatment strategies in TBI patients.
12) Measurement:
Measurement involves the quantification of blood glucose levels in patients. Accurate measurement is crucial for evaluating the physiological state during TBI management. The study noted a correlation between blood glucose measurements and injury severity, underscoring the need for monitoring glucose as a prognostic indicator.
13) Edema (Oedema):
Oedema refers to the swelling resulting from excess fluid accumulation in tissues, including the brain post-injury. Understanding the relationship between hyperglycemia and edema is essential, as high glucose levels may exacerbate oedema, leading to worse outcomes. The study touches on these complexities in TBI recovery.
14) Indian:
Indian refers to a demographic group within the study, highlighting ethnic diversity. The study included a proportion of Indian patients (14.6%). Understanding the ethnic composition aids in assessing how various factors, including cultural and socioeconomic differences, may affect TBI outcomes and recovery processes.
15) Death:
Death is the ultimate adverse outcome analyzed in the study. The findings suggest a strong correlation between elevated blood glucose levels and increased mortality risk in TBI patients. Studying these relationships informs clinical decision-making and emphasizes the importance of managing hyperglycemia in high-risk groups.
16) Bell:
Bell refers to the distribution pattern observed in blood glucose levels, following a bell-shaped curve in the study data. This indicates varying glucose levels among different severity groups of TBI. Understanding this distribution aids in recognizing typical physiological responses and deviations that warrant clinical attention.
17) Inflammation:
Inflammation is a critical element of the body’s response to injury. The study suggests that hyperglycemia may exacerbate inflammatory processes in TBI. Understanding the interplay between glucose metabolism and inflammation can help formulate treatment protocols aimed at reducing secondary brain injury and improving patient outcomes.
18) Calculation:
Calculation refers to the statistical methods used to analyze the data collected from the study participants. This includes determining mean and standard deviations for blood glucose levels and interpreting their significance in relation to TBI severity and outcomes, ultimately guiding clinical recommendations.
19) Observation:
Observation denotes the careful monitoring and data collection throughout the study. Observational data contributed significantly to understanding the relationship between blood glucose levels and TBI outcomes, allowing for assessments that can inform future research and clinical practices regarding management strategies.
20) Collecting:
Collecting refers to the systematic gathering of data from TBI patients over the study period. This involved compiling clinical details, glucose measurements, and outcome scores. Effective data collection is crucial for obtaining reliable results that enable valid conclusions regarding the implications of hyperglycemia in TBI.
21) Inference:
Inference refers to the conclusions drawn from the study’s findings regarding blood glucose levels and TBI outcomes. Inferences made about hyperglycemia's role as a predictor of TBI severity guide further research and clinical practices, reinforcing the importance of monitoring glucose levels for improved patient care.
22) Matta (Mattam):
Matta refers to one of the authors cited in the study, who contributed to research around traumatic brain injury. Reference to Matta in the literature underscores the existing body of work concerning relationships between acute stress responses, inflammation, and outcomes in TBI, enriching the context of the current study.
23) Joshi (Josi):
Joshi is another author mentioned in the study, indicating contributions to research and knowledge in the field of traumatic brain injury. Citing authors like Joshi provides credibility to the study, tying findings to previous efforts and reinforcing the continuous need for investigation into TBI management.
24) Sign:
Sign refers to indicators or markers, such as blood glucose levels, that signify the condition or progression of TBI. Blood glucose can serve as a significant clinical sign of metabolic distress and injury severity in patients, which mandates attention in both acute and stable phases of TBI recovery.
25) Fish:
Fish refers to a key author referenced in studies about the physiological responses to trauma, particularly concerning the neuroendocrine response to stress. Citing Fish’s work lends authority to the study’s findings, highlighting established correlations between trauma response, glucose metabolism, and patient outcomes in TBI.
26) Road:
Road pertains primarily to the mechanism of injury among study participants, with a majority involved in road traffic accidents. Road-related injuries are significant contributors to TBI cases, emphasizing the need for research focused on prevention, management, and rehabilitation concerning traffic safety and brain injuries.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Blood Glucose Levels in Traumatic Injury Patients: An Observational Study’. Further sources in the context of Science might help you critically compare this page with similair documents:
Mortality, Surgical intervention, Future research, Blood-pressure, Gender difference, Follow-up, Patient, Significant difference, Observational study, Blood brain barrier, Limitations of the study, Sympathetic nervous system, Economic burden, Blood sugar, Age distribution, Demographic pattern, Blood glucose level, Blood glucose concentration, Statistical analyses, Blood glucose, Mean Arterial Pressure, Hyperglycaemia, Catecholamines, Glasgow Coma Scale, Traumatic Injury, Head injury, Acute treatment, Age-related decline, Glucose concentration, Emergency Department, Prognostic value, Traumatic brain injury, Prognostic Factor, Patient Outcome, Glucose level, Negative prognostic factor, Severe head injury, Favourable outcome, Persistent vegetative state, Persistent hyperglycemia, Poor outcome, Independent risk factor, Mean blood glucose, Department of Neurosurgery, Favorable outcome, Secondary injury, Brain injury, Brain tissue, Mean blood glucose level, Norepinephrine, Extradural haemorrhage, Subdural haemorrhage, Tight control, Independent predictor.
Concepts being referred in other categories, contexts and sources.