Body Mass Index Interaction Effects with Hyperglycemia and Hypocholesterolemia Modify Blunt Traumatic Brain Injury Outcomes: a Retrospective Study

Overview

Journal Int J Burns Trauma

Date 2021 Jan 27

PMID 33500843

Citations 3

Authors

Gregory S Huang

Carl M Dunham

Elisha A Chance

Barbara M Hileman

Daniel J DelloStritto

Affiliations

Soon will be listed here.

Abstract

Introduction: There is controversy regarding obesity or body mass index (BMI) effects on postinjury mortality and mechanical ventilation. The aim was to assess outcome associations with BMI and postinjury blood glucose and cholesterol.

Method: Adult blunt traumatic brain injury patients admitted to a level I trauma center and requiring ≥ 3 days of intensive care were investigated. Admission blood glucose and day-4 total cholesterol were captured from the medical records. Cholesterol ratio was calculated by dividing day-4 values by published national normative levels according to sex, age, and injury date.

Results: The parent cohort included 588 patients. The ventilator days ≥ 10 or died group, when compared to the ventilator days < 10 and lived group, had higher Injury Severity Score (ISS) (29.2±9.9 versus [vs.] 23.7±9.7, P < 0.0001), BMI (27.9±6.8 vs. 26.0±5.5, P = 0.0002), and admission glucose (182.6±79 vs. 155.4±59 mg/dl, P < 0.0001, n = 476) and lower emergency department Glasgow Coma Scale score (ED GCS) (6.9±4.7 vs. 10.3±5.0, P < 0.0001) and cholesterol ratio (0.64±0.2 vs. 0.70±0.2, P = 0.0018, n = 364). The ventilator days ≥ 10 or died group had independent associations with increased ISS (P = 0.0709), decreased ED GCS (P = 0.0078), and increased BMI÷cholesterol ratio (P = 0.0003). The ventilator days ≥ 10 or died group had independent associations with increased ISS (P = 0.0013), decreased ED GCS (P < 0.0001), and increased BMI × glucose (P < 0.0001). Ventilator days were increased with higher ISS (P < 0.0001), BMI (P = 0.0014) and glucose (P = 0.0031) and with lower ED GCS (P < 0.0001) and cholesterol ratio (P = 0.0004). Ventilator days had independent associations with increased ISS (P < 0.0001), decreased ED GCS (P = 0.0041), and increased BMI÷cholesterol ratio (P = 0.0010). Ventilator days had independent associations with increased ISS (P < 0.0001), decreased ED GCS (P < 0.0001), and increased BMI × glucose (P = 0.0041).

Conclusion: For TBI patients, valid risk assessment measurements include ISS (anatomic injury burden), ED GCS (brain function), BMI (preinjury weight status), admission glucose (postinjury metabolism), and day-4 cholesterol ratio (postinjury inflammation).

Citing Articles

Metabolic disorders after traumatic brain injury: a narrative review of systemic consequences.

Kursancew A, Faller C, Piva-Uchida E, Benedet I, Maciel P, de Figueredo S Metab Brain Dis. 2025; 40(1):93.

PMID: 39776307 DOI: 10.1007/s11011-024-01524-3.

Patients with Severe Trauma Having an Injury Severity Score of 24 and above Develop Nutritional Disorders.

Mizuochi M, Yamaguchi J, Chiba N, Kinoshita K Diagnostics (Basel). 2024; 14(12).

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Low total cholesterol predicts early death in children with hemophagocytic lymphohistiocytosis.

Xiao L, Xu X, Zhang Z, Dou Y, Guan X, Guo Y Front Pediatr. 2023; 10:1006817.

PMID: 36699307 PMC: 9869152. DOI: 10.3389/fped.2022.1006817.

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-Matched Population. 2020, , 4266.

Mekitarian Filho E Int J Environ Res Public Health. 2021; 18(5).

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