Prognostic implications of hyperglycaemia in paediatric head injury |
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Authors: | A. Chiaretti R. De Benedictis A. Langer C. Di Rocco C. Bizzarri A. Iannelli G. Polidori |
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Affiliation: | (1) Paediatric Intensive Care Unit, Institute of Paediatrics, Catholic University, Largo A. Gemelli, 8, I-00168 Rome, Italy Tel.: +39-6-30 15 52 03 Fax: +39-6-33 83 211, IT;(2) Department of Paediatric Neurosurgery, Catholic University, Largo A. Gemelli, 8, I-00168 Rome, Italy, IT |
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Abstract: | Fifty children with head injury were evaluated in an attempt to estabilish a correlation between post-traumatic hyperglycaemia and long-term outcome. In all the patients, the blood glucose level was measured on admission and on the days following the trauma (threshold of normal value set at 150 mg/dl). Hyperglycaemia was seen more frequently in children with severe head injury than in those with mild and moderate head injury. It was present in 87.5% of the patients with a Glasgow Coma Score (GCS) ≤8 (the average blood glucose level on admission was 237.8±92 mg/dl), in 60% of the patients with a GCS of 9–12 (178±78.7 mg/dl) and only in 25% of those with a GCS of 13–15 (131.5±39 mg/dl). A close correlation was also seen between the outcome and the blood glucose level. In fact, the blood glucose on admission was higher in the patients with a poor outcome, i.e. in those having a Glasgow Outcome Score (GOS) of 2 or 3 and in those who died (GOS 1), than in the patients with a good outcome (GOS of 4 or 5). Finally, hyperglycaemia persisted beyond the first 24 h after trauma in all the children who died or who survived with a poor outcome. Hyperglycaemia, and especially its persistence over time, appears to be an important negative prognostic factor in children with head injury. Received: 14 May 1998 |
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Keywords: | Children Head injury Hyperglycaemia Outcome |
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