Post-traumatic brain injury (TBI) blood sugar (BG) and its relation to inpatient rehabilitation outcome

Research Objectives: To explore how the post-TBI BG may contribute to the outcome of inpatients at the rehabilitation discharge.

Design: A retrospective cohort study with the following data from the electronic medical record (EMR): the first Glasgow Coma Scale (GCS) at the emergency room, the BG and systolic blood pressure (SBP) during the first 48 hours of the emergency room arrival, and the demographic variables.

Setting: A public hospital specializing in medical rehabilitation, serving diverse patients.

Participants: Patients with TBI (N=224) who met the inclusion criteria of the TBI Model Systems with the complete data in the EMR, attended inpatient rehabilitation from 1/1/2019 to 12/31/2020.

Interventions: Not applicable.

Main Outcome Measures: The Disability Rating Scale (DRS) scored retrospectively to reflect the discharge status of the inpatient rehabilitation.

Results: The independent variables included in the ANCOVA were the mean BG (MGB), cutoff of 140 mg/dL, the highest SBP, and GCS with a dependent variable of the DRS. This analysis was significant (p = 0.0001; R2 = 0.2159). A general linear model with multiple comparisons revealed a nonlinear relationship between MBG and DRS, therefore, the MBG was separated into two groups, MBG1 (MBG < 140 mg/dL) and MBG2 (MBG > =140 mg/dL). Two regression models were then computed with each MGB group, significant independent variables being SBP, GCS, and age of onset. Both models are significant, MBG1 (p = 0.0221, R2 = 0.0848) and MBG2 (p = 0.0001, R2 = 0.2875).

Conclusions: The MBG of TBI patients during the first 48 hours of admission to the emergency room has a significant negative impact on the outcome of inpatient rehabilitation. The impact appeared to be higher among those with MBG >= 140 mg/dL.

Author(s) Disclosures: Nothing to disclose.