Study On The Relationship Between Blood Glucose Management And Prognosis Of Multiple Trauma Patients

Background: To investigate the best blood glucose level in multiple trauma patients,which help better improve outcomes for those patients.Methods: A multiple-center,retrospective cohort study using data from two Databases(Medical Information Mart for Intensive Care,Mimic-Ⅲ and e ICU Collaborative Reasearch Database,e ICU-CRD)was performed.Logistic regression analysis was performed to explore the risk factors and the ROC(receiver operator characteristic)curves were used to reflect the predictive value of these factors.Finally,we identify the best glucose control range of multiple trauma patients.Results: 1662 patients were finally analyzed in our study.Multivariate logistic regression analysis showed that age,respiratory rate at admission,WBC,platelet,PT,PTT,creatinine,72-hour blood glucose(72h Glu-max),168-hour blood glucose(168h Glu-max)and ventilation were the independent risk factors for in-hospital mortality in multiple trauma patients(P<0.05).Higher blood glucose level was associated with poor prognosis,but not in diabetes patients.Additionally,tight-glucose control group(glucose level<144mg/d L)was associated with better prognosis.Conclusion: It is necessary for multiple trauma patients to strictly control the glucose level.The best goal of the tight glucose control in multiple trauma patients was stably maintained below 180 mg/d L for one week after admission.Meanwhile,when glucose level was controlled below 144 mg/d L,the length of stay and ICU length of stay significantly decreased.