Abstract Details

Title Glycemia as a Key Determining Factor for Survival and Neurological Recovery After Acute Traumatic Spinal Cord Injury

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) S48 - Neurocritical Care: Traumatic Brain Injury and Goals-of-care Decision-making (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Objective This study examined the potential association of glycemia in the hyperacute stage and outcomes after acute traumatic spinal cord injury (SCI).

Background Hyperglicemia has adverse effects on neuronal recovery after brain injury, but its effects after SCI have not been well studied.

Design/Methods This retrospective cohort study includes all patients who were enrolled into the National Spinal Cord Injury Study 3 (NASCIS-3). Data on the glycemia within 24 hours, at 48 hours and at day 7 after acute SCI were examined as potential determinants of survival within the first year, and neurological recovery at 6 weeks, at 6 months and at 1 year post-SCI. Neurological recovery included the NASCIS motor, sensory and pain scores.

Results There were 76 women and 423 men with mean age of 35.7 years who mostly sustained cervical SCI due to motor vehicle accidents or falls. On admission, 96.6% of the individuals had hyperglycemia. There was significant overtime decline in the glycemia within the first week post-injury (p<0.01). Using regression analyses, higher glycemia at 24 hours was associated with lower motor, sensory and pain scores within 6 months, but not at 1 year post-SCI. Glycemia at 48 hours and day 7 was not associated with motor, sensory and pain scores within first year post-SCI, but a poorer motor recovery and a greater pain score at 1 year post-SCI related to higher glycemia at 48 hours. Only hyperglycemia at day 7 was associated with greater mortality after SCI.

Conclusions Our results suggest that hyperglycemia at day 7 was associated with greater 1-year mortality post-SCI. Among the survivors, glycemia at 24 and 48 hours, and at day 7 post-injury did not adversely affect the individuals’ neurological recovery at 1 year post-SCI. Future investigations are required to examine whether glycemic control in the hyperacute stage improves survival post-SCI.

Authors/Disclosures
Julio C. Furlan, MD, PhD, MBA, MSc, FAAN (Lyndhurst Centre, Toronto Rehabilitation Institute; University of Toronto) PRESENTER	The institution of Dr. Furlan has received research support from Wings for Life Spinal Cord Research Foundation. The institution of Dr. Furlan has received research support from Craig H Neilsen Foundation. The institution of Dr. Furlan has received research support from Ontario Neurotrauma Foundation. The institution of Dr. Furlan has received research support from Cervical Spine Research Society. The institution of Dr. Furlan has received research support from J P Bickell Foundation. The institution of Dr. Furlan has received research support from Praxis Spinal Cord Institute. The institution of Dr. Furlan has received research support from Cervical Spine Research Society.

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