A Comparative Study on the Trends of Blood Glucose, Serum Triglycerides, and CRP-Based Levels in Correlation with GCS among Patients with Traumatic Head Injury.

Abstract

Background: Traumatic head injury, which has a high mortality rate, can present as mild contusions, hemorrhages (subdural, extradural, intraparenchymal), diffuse axonal injuries, or direct penetrating injuries. Glasgow Coma Scale (GCS) is used to assess the severity of head injury. Stress-induced hyperglycemia associated with traumatic brain injury has high mortality compared with hyperglycemia in diabetic patients. Stress-induced hyperglycemia not only occurs due to head injury but also serves as a predictor of its outcome. C-reactive protein (CRP) levels are also associated with severity of head injury. Triglyceride levels are said to correlate with neuroinflammation and apoptosis, thus pivotal with severity of traumatic brain injury. With this background, this study aims to compare the levels of blood glucose, CRP, and serum triglycerides in patients with traumatic head injury according to their level of consciousness.

Objectives: This article compares the levels of blood glucose, CRP, and serum triglyceride in traumatic head injury patients according to their GCS and assesses their trends.

Materials and methods: Patients were divided into two groups (patients with GCS ≤ 8 as group 1 and patients with GCS > 8 as group 2). Blood was collected in these patients at admission, 24 hours after admission, and 48 hours after admission. Glucose was estimated at admission, 24 hours, and 48 hours after admission. CRP and triglycerides were estimated after 24 and 48 hours after admission. The levels were compared between groups and also their trends were assessed.

Statistics: Mean and standard deviation were calculated for the above parameters using Excel. Statistical analysis was done using SPSS software version 26. Statistical significance was assessed using " t -test" and "analysis of variance." A p -value of < 0.05 was considered statistically significant.

Results: Group 1 showed increased levels of glucose after 24 and 48 hours compared with group 2. CRP showed increased levels in group 1 compared with group 2. There was no significant difference in triglyceride levels between the two groups. Levels of blood glucose showed decreasing trends in group 2. CRP showed increasing trend in group 1. Triglyceride levels showed increasing trend in both the groups.

Conclusion: The decreasing trend in glucose levels in group 2 and increasing trend in CRP levels in group 1 are due to the same pathogenesis, which is associated with the severity of head injury. Increased trends in triglyceride levels were seen in both the groups. Since the association of levels of these parameters and their trends with severity of head injury, regular and serial monitoring of these analytes may be used as prognostic marker.