Admission hyperglycaemia as a prognostic indicator of outcome in major trauma patients at Bugando Medical Centre, Mwanza, Tanzania

Abstract

Background: Admission hyperglycemia has been reported to be associated with poor outcomes among patients with major trauma. However, most of the available literature on this subject has been conducted in the developed world. This study aimed to determine the association between admission hyperglycemia and the outcome of major trauma patients admitted to Bugando Medical Centre.

Methods: This was a prospective cohort study, involving major trauma patients admitted to Bugando Medical Centre (BMC) within 6 months from Sept 2017 to February 2018. The exposure was admission hyperglycemia (>11.1mmol/l) and non-exposure was normoglycemia (≤11.1mmol/l).

Results:  A total of 217 patients (M: F ratio = 4.1: 1) were recruited. Their ages ranged from 4 to 97 years with a median age of 31 years. Out of 217 patients, 106 (48.8%) were hyperglycemic and the remaining 111(51.2%) were normoglycemic. The overall median days of length of hospital stay (LOS) was 15 days. There was no statistically significant association between admission hyperglycemia and LOS (p =0.875). In this study, 73 patients died giving a mortality of 33.6%. Patients with admission hyperglycemia (>11.1mmol/l) had significantly higher mortality as compared to normoglycemic patients (≤11.1mmol/l) (p < 0.001).

Conclusion: This study found that admission hyperglycemia was statistically significantly associated with increased mortality among major trauma patients at BMC. Therefore, there is a need to institute regular monitoring of blood sugar levels among these patients and give appropriate treatment to those found with elevated blood sugar levels.