The Relationship between HbA1C Levels and Clinical Outcome in
Patients with Traumatic Brain Injury:
A Prospective Study

 

Sajad Shafiee¹, Misagh Shafizad¹, Dorsa Marzban², Samad Karkhah^{3, 4},
Mohammad Javad Ghazanfari⁵, Amir Emami Zeydi⁶

 

¹Department of Neurosurgery, Orthopedic Research Center, Mazandaran University of Medical Sciences,
Sari, Iran
²Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
³Department of Medical-Surgical Nursing, School of Nursing and Midwifery,
Guilan University of Medical Sciences, Rasht, Iran
⁴Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
⁵Department of Medical-Surgical Nursing, School of Nursing and Midwifery,
Kashan University of Medical Sciences, Kashan, Iran
⁶Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery,
Mazandaran University of Medical Sciences, Sari, Iran

 

SUMMARY

 

 Introduction/Aim: Recently, hemoglobin A1c (HbA1c) has been suggested as a predictor of mortality and poor clinical outcome in patients with trauma. The aim of this study was to evaluate the relationship between HbA1c values and clinical outcome in patients with traumatic brain injury (TBI).
Methods: In a cross-sectional study, a total of 133 TBI patients referred to the emergency department of Imam Khomeini Hospital in Sari, Mazandaran, Iran were evaluated. After transferring the patients to the neurosurgery ward, their HbA1c, fasting blood glucose (FBG) and postprandial glucose (PPG) were measured. Also, patients' Glasgow Coma Scale (GCS) score was recorded at the time of admission, 24 hours after admission and at the time of discharge from the hospital.
Results: The mean of GCS score of patients at the time of admission, 24 hours after admission, and at the time of discharge were 9.02 (2.09), 10.07 (2.16), and 12.98 (1.82), respectively. The mean GCS score of patients with HbA1c < 5.7% was significantly lower than of patients with HbA1c = 5.7 - 6.5% at the time of admission (p < 0.05). At 24 hours after admission, the mean GCS score of patients with HbA1c < 5.7% was significantly lower than in other groups (p < 0.05). However, at the time of discharge, the mean GCS score of patients with HbA1c > 6.5% was significantly lower than in patients with HbA1c = 5.7 - 6.5% (p < 0.05). Over time, the mean of GCS scores in all patients significantly increased (p < 0.001).
Conclusion: According to the results of this study it seems that HbA1c measurements cannot provide clear information about the clinical outcome of patients with TBI.

 Keywords: HbA1c, clinical outcome, brain trauma, head trauma, traumatic brain injury

 

Corresponding author:

Amir Emami Zeydi

e-mail: emamizeydi@yahoo.com