Kafa Travmasının Akut Döneminde Kan Glikozu Düzeyi ile Prognoz Arasındaki İlişkinin Değerlendirilmesi
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Tarih
2004
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info:eu-repo/semantics/openAccess
Özet
AMAÇ: Kafa travmalarının akut döneminde ölçülen kan glikozu düzeyi ile Glaskow Koma Skalası (GKS) skoru ve prognoz arasındaki ilişki değerlendirildi. GEREÇ VE YÖNTEM: Çalışmaya izole kafa travması geçirdikten sonra ilk üç saat içinde hastaneye yatırılan 62 hasta (26 kadın, 36 erkek; ort. yaş 61; dağılım 4-76) alındı. Tüm hastalarda GKS skoru belirlendi; kan glikozu düzeyi ölçüldü. Bilgisayarlı beyin tomografisi (BT) bulguları, beyin ödemi, kırık, kontüzyon, kanama ve kombine patoloji olarak sınıflandırıldı. Kan glikozu düzeyi ile GKS, sonuç ve BT bulguları arasında ilişki araştırıldı. BULGULAR: Bilgisayarlı tomografi incelemesinde 15 olguda (%24.2) beyin ödemi, dokuz olguda (%14.5) kanama, dört olguda kırık (%6.5), iki olguda kontüzyon (%3.2) saptandı; 32 olguda (%51.6) ise birden fazla patoloji vardı. Glaskow Koma Skalası skoru ortalaması 8 (dağılım 3-13) bulundu. Otuz yedi olguda (%59.7) GKS skoru 8 veya altında; 25 olguda (%40.3) 8’in üzerinde idi. Ortalama kan glikozu düzeyi 219 mg/dl (dağılım 136-397 mg/dl) bulundu. Glaskow Koma Skalası skoru 8 veya altında olan olgularda ortalama kan glikozu düzeyi 293 mg/dl ölçüldü; bu olguların 18’i kaybedildi. Kan glikozu düzeyi ile GKS skoru arasında (p0.01) ve GKS ile ölüm arasında anlamlı negatif ilişki (p0.01); kan glikozu düzeyi ile ölüm arasında anlamlı ilişki bulundu (p0.01). Bilgisayarlı tomografi bulguları ile ölüm ve kan glikozu düzeyi arasında anlamlı ilişki bulunmadı. SONUÇ: Kafa travmalarının erken döneminde yüksek kan glikozu düzeyi prognozun kötü olacağının göstergesi olabilir.
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 . 0 1 ), and (ii) GCS scores and mortality ( p < 0 . 0 1 ). Blood glucose levels were significantly correlated with mortality (p<0.01). C o m p u t e d 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.
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 . 0 1 ), and (ii) GCS scores and mortality ( p < 0 . 0 1 ). Blood glucose levels were significantly correlated with mortality (p<0.01). C o m p u t e d 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.
Açıklama
Anahtar Kelimeler
Kan glikozu, beyin yaralanmaları, kranyoserebral travma, Glaskow Koma Skalası, hiperglisemi, prognoz, sağkalım oranı, Blood glucose, brain injuries, craniocerebral trauma, Glasgow Coma Scale, hyperglycemia, prognosis, survival rate
Kaynak
Ulusal Travma Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
3
Künye
Bayır, A., Ak, A., (2004). Kafa Travmasının Akut Döneminde Kan Glikozu Düzeyi ile Prognoz Arasındaki İlişkinin Değerlendirilmesi. Ulusal Travma Dergisi, 10(3), 192-195.
