Admission Blood Glucose as a Predictor of Morbidity and Mortality in Polytraumatized Patients

Overview

In polytrraumatized patients, Does hyperglycaemia on admission increase the risk of morbidity and mortality compared to polytraumatised patients with normal blood glucose level ?

Study Type

  • Study Type: Observational [Patient Registry]
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: September 1, 2020

Detailed Description

Trauma is still the leading cause of death in young adults and a major cause of morbidity and mortality at all ages.(1,2). Polytrauma is defined as injury to several physical regions or organ systems, where at least one injury or the combination of several injuries are life threatening with the severity of injury being equal or >16 on the scale of the Injury Severity Score (ISS). Prediction of mortality in trauma patients is an important part of trauma care (3). The trauma and injury severity score (TRISS) and Acute Physiology and Chronic Health Evaluation IV (APACHE IV) are used commonly to predict injury severity and risk of mortality. Although it is regarded as the international standard in trauma scoring, it has complex calculating and incorporates the Glasgow Coma Scale (GCS) for neurological evaluation (4). Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed(5) . Many studies have revealed alteration in glucose metabolism in trauma and proportional relation of its high level to the degree of injury (6). hyperglycaemia is associated with similar complications as uncontrolled diabetes, including an increased mortality, an increased number of infectious complications, and poor wound healing. The presence of elevated blood glucose also impedes normal host defences against infection and impairs the normal inflammatory response (7.8).

- Therefore, this study will be conducted to compare between alterations in easy and rapid predictors as glucose level, base deficit and lactate and difficult and slow predictors as TRISS and APACHE IV. So, it could be considered an early and easy rapid predictor of outcome .

Interventions

  • Diagnostic Test: laboratory
    • Arm

Clinical Trial Outcome Measures

Primary Measures

  • Admission blood glucose as a predictor of morbidity and mortality in polytraumatized patients
    • Time Frame: baseline
    • to investigate the admission blood glucose level as a predictor of morbidity and mortality in poly traumatized patients

Secondary Measures

  • Admission blood glucose as a predictor of morbidity and mortality in polytraumatized patients
    • Time Frame: baseline
    • correlation of blood glucose level to serum lactate , interlukin6 , C reactive protein , coagulation profile and their use as biomarkers in polytraumatized patients

Participating in This Clinical Trial

Inclusion Criteria

  • • Age >= 18 years
  • Polytrauma ISS >= 18
  • Recent polytrauma patients who are directly transferred by the ambulance from the scene of accident to assiut university hospital and did not receive resuscitative measurements in another hospital

Exclusion Criteria

  • known co-morbidities affecting blood glucose level like :
  • Pregnant women
  • Diabetic patients

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Investigator Details

  • Lead Sponsor
    • Assiut University
  • Provider of Information About this Clinical Study
    • Principal Investigator: tamer refaat hanna armanious, Assistant Lecturer – Assiut University
  • Overall Official(s)
    • Hossam Abubeih, ass.prof, Study Director, Assiut University
    • fasil adam, prof, Study Director, Assiut University
  • Overall Contact(s)
    • tamer armanious, MD, +201203523938, tamerrefaat2244@gmail.com

References

Laird AM, Miller PR, Kilgo PD, Meredith JW, Chang MC. Relationship of early hyperglycemia to mortality in trauma patients. J Trauma. 2004 May;56(5):1058-62.

Lichtveld RA, Panhuizen IF, Smit RB, Holtslag HR, van der Werken C. Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital. Eur J Trauma Emerg Surg. 2007 Feb;33(1):46-51. doi: 10.1007/s00068-007-6097-6. Epub 2007 Feb 27. Erratum in: Eur J Trauma Emerg Surg. 2007 Apr;33(2):201.

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