Blood Glucose, High Clinical Trial
Official title:
Admission Blood Glucose as a Predictor of Morbidity and Mortality in Polytraumatized Patients
In polytrraumatized patients, Does hyperglycaemia on admission increase the risk of morbidity and mortality compared to polytraumatised patients with normal blood glucose level ?
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 .
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