Stress Induced Hyperglycemia In Trauma

NCT02999386 | Completed

• 1 other identifier: 14471/14
• Study Type: observational
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

The clinical relevance of the observed stress induced hyperglycemia in trauma patients remains unclear. The earlier studies suggested the implications of cytokines in stress induced hyperglycemia and the outcomes after trauma. To date, there is little information available regarding the effect of diabetic hyperglycemia (occult or known) on outcomes after trauma and whether these patients represent a distinct group with differential outcomes when compared to those with stress-induced hyperglycemia. Herein, the purpose of this study is to identify the incidence of stress induced hyperglycemia as well as diabetic hyperglycemia in trauma patients and to investigate the association between proinflammatory cytokine levels and hyperglycemia in our trauma population.

Conditions

Trauma; Stress Induced Hyperglycemia; Diabetes Mellitus

Keywords

stress, hyperglycemia, inflammatory markers, trauma, HbA1c; interleukin-6

Outcome Measures

Primary Outcomes (1)

• All cause Mortality

  30 days

Secondary Outcomes (4)

• Pneumonia

  30 days

• Sepsis

  30 days

• Multiorgan failure

  30 days

• Hospital length of stay

  1 year

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All adult (≥18 years) trauma patients required hospital admission will be screened for participation in this study.

You may qualify if:

• All adult (≥18 years) male and female trauma patients consented for participation and have been investigated for random plasma glucose level and HbA1C measured within 5 hours of hospital admission will be included in the study.

You may not qualify if:

• Patients who descend to participate or in whom random serum glucose level and HbA1C not measured within 5 hours of hospital admission will be excluded from the study.
• Also, vulnerable populations (children, and pregnant women), and alcoholics will be excluded from the study.

Sponsors & Collaborators

• Hamad Medical Corporation: lead

Study Sites (1)

Hamad Medical Coorporation

Doha, 3050, Qatar

Location

Related Publications (10)

• McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin. 2001 Jan;17(1):107-24. doi: 10.1016/s0749-0704(05)70154-8.

  PMID: 11219223 BACKGROUND

• Yendamuri S, Fulda GJ, Tinkoff GH. Admission hyperglycemia as a prognostic indicator in trauma. J Trauma. 2003 Jul;55(1):33-8. doi: 10.1097/01.TA.0000074434.39928.72.

  PMID: 12855878 BACKGROUND

• Laird AM, Miller PR, Kilgo PD, Meredith JW, Chang MC. Relationship of early hyperglycemia to mortality in trauma patients. J Trauma. 2004 May;56(5):1058-62. doi: 10.1097/01.ta.0000123267.39011.9f.

  PMID: 15179246 BACKGROUND

• Kerby JD, Griffin RL, MacLennan P, Rue LW 3rd. Stress-induced hyperglycemia, not diabetic hyperglycemia, is associated with higher mortality in trauma. Ann Surg. 2012 Sep;256(3):446-52. doi: 10.1097/SLA.0b013e3182654549.

  PMID: 22868366 BACKGROUND

• Bosarge PL, Shoultz TH, Griffin RL, Kerby JD. Stress-induced hyperglycemia is associated with higher mortality in severe traumatic brain injury. J Trauma Acute Care Surg. 2015 Aug;79(2):289-94. doi: 10.1097/TA.0000000000000716.

  PMID: 26218699 BACKGROUND

• Rovlias A, Kotsou S. The influence of hyperglycemia on neurological outcome in patients with severe head injury. Neurosurgery. 2000 Feb;46(2):335-42; discussion 342-3. doi: 10.1097/00006123-200002000-00015.

  PMID: 10690722 BACKGROUND

• Wei Y, Chen K, Whaley-Connell AT, Stump CS, Ibdah JA, Sowers JR. Skeletal muscle insulin resistance: role of inflammatory cytokines and reactive oxygen species. Am J Physiol Regul Integr Comp Physiol. 2008 Mar;294(3):R673-80. doi: 10.1152/ajpregu.00561.2007. Epub 2007 Dec 19.

  PMID: 18094066 BACKGROUND

• Esposito K, Marfella R, Giugliano D. Plasma interleukin-18 concentrations are elevated in type 2 diabetes. Diabetes Care. 2004 Jan;27(1):272. doi: 10.2337/diacare.27.1.272. No abstract available.

  PMID: 14694002 BACKGROUND

• Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet. 2009 May 23;373(9677):1798-807. doi: 10.1016/S0140-6736(09)60553-5.

  PMID: 19465235 BACKGROUND

• El-Menyar A, Asim M, Mir F, Hakim S, Kanbar A, Siddiqui T, Younis B, Ahmed K, Mahmood I, Atique S, Al Jogol H, Taha I, Mustafa F, Alabdallat M, Abdelrahman H, Peralta R, Al-Thani H. Patterns and Effects of Admission Hyperglycemia and Inflammatory Response in Trauma Patients: A Prospective Clinical Study. World J Surg. 2021 Sep;45(9):2670-2681. doi: 10.1007/s00268-021-06190-5. Epub 2021 Jun 11.

  PMID: 34117510 DERIVED

MeSH Terms

Conditions

Wounds and Injuries; Diabetes Mellitus; Hyperglycemia

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Study Officials

• Ayman El-Menyar, MD

  Hamad Medical Coorporation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: INDUSTRY
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: December 15, 2016
• First Posted: December 21, 2016
• Study Start: October 1, 2016
• Primary Completion: December 1, 2019
• Study Completion: December 1, 2019
• Last Updated: July 23, 2020

Record last verified: 2020-07

Data Sharing

• IPD Sharing: Will not share

Locations

QA (1)