[An evaluation of the relationship between blood glucose level and prognosis in acute phase of head injuries].

Background: We evaluated the relationship between blood glucose level and Glasgow Coma Scale (GCS) and prognosis in acute phase of head injuries.

Methods: The study included 62 patients (26 females, 36 males; mean age 61 years; range 4 to 76 years) who were admitted within the first three hours following isolated head injuries. Initial GCS scores were determined and blood glucose levels were measured. Cranial computed tomography (CT) findings were classified as cerebral edema, fracture, contusion, hemorrhage, and multiple pathologies. Relationships were sought between GCS scores, outcome, CT findings, and blood glucose levels.

Results: Cranial CT findings were cerebral edema in 15 patients (24.2%), hemorrhage in nine patients (14.5%), fractures in four patients (6.5%), contusion in two patients (3.2%), and multiple injuries in 32 patients (51.6%). The mean GCS score was 8 (range 3 to 13), which was 8 or lower in 37 patients (59.7%), and above 8 in 25 patients (40.3%). The mean blood glucose level was 219 mg/dl (range 136 to 397 mg/dl) in the study group. It was 293 mg/dl in those with a GCS score of 8 or lower, of which 18 patients died. Significant inverse relationships were found between (i) blood glucose level and GCS scores (p<0.01), and (ii) GCS scores and mortality (p<0.01). Blood glucose levels were significantly correlated with mortality (p<0.01). Computed tomography findings were not correlated with mortality and blood glucose levels.

Conclusion: High blood glucose levels in acute phase of head injuries may be a sign for poor prognosis.