Objective To explore the impact of stress hyperglycemia(SHG)on in-patient outcomes and long-term prognosis in patients with severe traumatic brain injury(TBI).Methods A total of 127 severe TBI patients in Department of Neurosurgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,who were confirmed by imaging examination,Glasgow coma scale(GCS)from September 2018 to February 2024,were included retrospectively.All patients underwent emergency surgery,and were transferred to the neurosurgical intensive care unit for subsequent treatment.The past diabetes history was excluded.According to the postoperative random blood glucose situation,patients were divided into SHG group(blood glucose≥11.1 mmol/L,n=42)and normal blood glucose group(blood glucose＜11.1 mmol/L,n=85).The clinical data of patients in each group were collected to explore the clinical prognostic impact of SHG on patients with severe TBI.Results There was no statistically significant difference between the SHG group and the normal blood glucose group in terms of age,preoperative brain herniation,body mass index,duration of neurological intensive care unit stay,postoperative coagulation dysfunction,liver and kidney dysfunction,etc.The incidence of severe pulmonary infection,mortality rate,long-term 3-month mortality rate and poor neurological function recovery in the SHG group were significantly higher than those in the normal blood glucose group,and the differences were statistically significant(P＜0.05).Conclusions SHG is a high-risk factor for postoperative severe pulmonary infection and in-hospital mortality in patients with severe TBI,and it is a risk factor affecting the long-term prognosis of patients with severe TBI.
severe traumatic brain injurystress hyperglycemiasurgeryoutcome in hospitallong term prognosis
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