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Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population

Author

Listed:
  • Yu-Chin Tsai

    (Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
    Indicates equal contribution to authorship as the first author.)

  • Shao-Chun Wu

    (Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
    Indicates equal contribution to authorship as the first author.)

  • Ting-Min Hsieh

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

  • Hang-Tsung Liu

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

  • Chun-Ying Huang

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

  • Sheng-En Chou

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

  • Wei-Ti Su

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

  • Shiun-Yuan Hsu

    (Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

  • Ching-Hua Hsieh

    (Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan)

Abstract

Background: Hyperglycemia at the time of hospital admission is associated with higher morbidity and mortality rates in patients with traumatic brain injury (TBI). Using data from the Chang Gung Research Database (CGRD), this study aimed to compare mortality outcomes between patients with stress-induced hyperglycemia (SIH), diabetic hyperglycemia (DH), and nondiabetic normoglycemia (NDN). The study occurred at Keelung, Linkou, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals (CGMHs). Methods: A total of 1166, 6318, 3622, and 5599 health records from Keelung, Linkou, Chiayi, and Kaohsiung CGMHs, respectively, were retrieved from the CGRD for hospitalized patients with TBI between January 2001 and December 2015. After propensity score matching for sex, age, and Glasgow Coma Scale (GCS) score, the matched cohorts were compared to evaluate differences in the primary outcome between patients with SIH, DH, and NDN. In-hospital mortality was the primary outcome. Results: The analysis of matched patient populations revealed that at the Kaohsiung CGMH, patients with SIH had 1.63-fold (95% CI: 1.09–2.44; p = 0.017) and 1.91-fold (95% CI: 1.12–3.23; p = 0.017) higher odds of mortality than patients with NDN and DH, respectively. Similar patterns were found at the Linkou CGMH; patients with SIH had higher odds of mortality than patients with NDN and DH. In contrast, at the Keelung CGMH, patients with SIH had significantly higher odds of mortality than those with NDN (OR: 3.25; 95% CI: 1.06–9.97; p = 0.039). At the Chiayi CGMH, there were no significant differences in mortality rates among all groups. Conclusions: This study’s results suggest that SIH and DH differ in their effect on the outcomes of patients with TBI. The results were similar between medical centers but not nonmedical centers; in the medical centers, patients with SIH had significantly higher odds of mortality than patients with either NDN or DH.

Suggested Citation

  • Yu-Chin Tsai & Shao-Chun Wu & Ting-Min Hsieh & Hang-Tsung Liu & Chun-Ying Huang & Sheng-En Chou & Wei-Ti Su & Shiun-Yuan Hsu & Ching-Hua Hsieh, 2020. "Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population," IJERPH, MDPI, vol. 17(12), pages 1-11, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:12:p:4266-:d:371677
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    References listed on IDEAS

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    1. Cheng-Shyuan Rau & Shao-Chun Wu & Yi-Chun Chen & Peng-Chen Chien & Hsiao-Yun Hsieh & Pao-Jen Kuo & Ching-Hua Hsieh, 2017. "Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia, Is Associated with Higher Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: Analysis of a Propensity Score-M," IJERPH, MDPI, vol. 14(11), pages 1-10, November.
    2. Cheng-Shyuan Rau & Shao-Chun Wu & Yi-Chun Chen & Peng-Chen Chien & Hsiao-Yun Hsieh & Pao-Jen Kuo & Ching-Hua Hsieh, 2017. "Mortality Rate Associated with Admission Hyperglycemia in Traumatic Femoral Fracture Patients Is Greater Than Non-Diabetic Normoglycemic Patients but Not Diabetic Normoglycemic Patients," IJERPH, MDPI, vol. 15(1), pages 1-10, December.
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    1. Yu-Chin Tsai & Shao-Chun Wu & Ting-Min Hsieh & Hang-Tsung Liu & Chun-Ying Huang & Sheng-En Chou & Wei-Ti Su & Shiun-Yuan Hsu & Ching-Hua Hsieh, 2021. "Reply to Comment on Tsai, Y.-C., et al. Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Ma," IJERPH, MDPI, vol. 18(5), pages 1-2, March.

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