Correlation between serum glucose profiles and injury severity among admitted trauma patients at Mulago hospital.
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INTRODUCTION: Blood glucose is highly sensitive to cellular injury secondary to trauma and possesses all properties of an ideal serum marker of systemic injury. Blood glucose levels are positively correlated with severity as measured by the injury severity score. Persistent hyperglycemia in critically injured trauma patients is highly predictive of increased ventilator days, infection, and mortality. In Uganda, trauma is the leading cause of mortality on surgical wards. The purpose of this study was to describe the association between serum glucose levels and injury severity. The information generated will help guide appropriate management of trauma patients and provide a basis for clinical studies on agents that suppress the inflammatory response. METHODS: A total of 291 admitted adult trauma patients were recruited into the study in regard to acceptable ethical standards. Their baseline blood glucose levels were assessed. This was repeated at 24, 48 and 72 hours. Anyone found to have hyperglycemia, HBA1c was measured to rule out preexisting diabetes mellitus, results were then communicated to the team managing the patient. Data were collected using an interviewer administered questionnaire. It was then analyzed and statistical associations calculated between injury severity and serum glucose levels. RESULTS: A total of 291 study subjects were recruited 84.9% males and 15.1 % females. Forty of the study participants (15.5%), 34 participants (15.3%), 9 participants (4.6%), and 21participants (11.4%), had hyperglycemia at admission, 24 hours, 48hrs and 72 hours respectively. No patient had hypoglycemia during the study period. A strong positive correlation was noted between serum glucose levels and severity of injury at an injury severity score more >25. CONCLUSION: Hyperglycaemia is a common finding among trauma patients in Mulago hospital in the first 24-48 hours of admission and is comparably related to the severity of trauma.