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- Title
Evaluating the Impact of Nutritional Risk on Stress-Induced Hyperglycemia and Trauma Patient Outcomes.
- Authors
Huang, Ching-Ya; Yen, Yuan-Hao; Hsieh, Ting-Min; Tsai, Ching-Hua; Hsu, Shiun-Yuan; Hsieh, Ching-Hua
- Abstract
Introduction: Stress-induced hyperglycemia (SIH) and malnutrition are common in trauma patients and are linked to worse outcomes. This study examined the influence of nutritional status, determined by the Geriatric Nutritional Risk Index (GNRI), on the incidence of SIH in trauma patients. Methods: A retrospective analysis was conducted on adult trauma patients admitted to a Level I trauma center from 1 January 2009 to December 31, 2021. Patients were categorized into four groups: SIH, diabetic hyperglycemia (DH), diabetic normoglycemia (DN), and non-diabetic normoglycemia (NDN). Nutritional status was assessed using GNRI: high risk (GNRI < 82), moderate risk (82 ≤ GNRI < 92), low risk (92 ≤ GNRI ≤ 98), and no risk (GNRI > 98). Incidence of SIH and outcomes were analyzed across GNRI groups. Results: SIH was associated with higher mortality across all GNRI groups compared to NDN, with the highest rate (45.7%) in the high-risk group. Mortality decreased as GNRI increased in all glucose groups. NDN patients had the lowest mortality rates across GNRI groups. There was no correlation between GNRI and SIH incidence (p = 0.259). Conclusion: SIH significantly influenced mortality across all nutritional status groups, with the highest impact in malnourished patients. Although malnutrition did not affect SIH incidence, both SIH and poor nutritional status independently contributed to worse trauma outcomes. Targeted management of hyperglycemia and nutritional deficiencies is crucial for improving survival.
- Subjects
TAIWAN; BLOOD sugar analysis; WOUNDS &; injuries; RISK assessment; PEARSON correlation (Statistics); MALNUTRITION; PATIENTS; RESEARCH funding; GLYCOSYLATED hemoglobin; QUESTIONNAIRES; NUTRITIONAL assessment; TRAUMA severity indices; EMERGENCY medical services; RETROSPECTIVE studies; HOSPITAL mortality; GLASGOW Coma Scale; DESCRIPTIVE statistics; CHI-squared test; AGE distribution; HYPERGLYCEMIA; TRAUMA centers; NUTRITIONAL status; PSYCHOLOGICAL stress; MEDICAL records; ACQUISITION of data; ONE-way analysis of variance; LENGTH of stay in hospitals; DATA analysis software; COMPARATIVE studies; DISEASE incidence; DISEASE risk factors; DISEASE complications
- Publication
Healthcare (2227-9032), 2024, Vol 12, Issue 17, p1746
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare12171746