Janett Kreutziger Volker Wenzel Andrea Kurz Mihai Adrian Constantinescu Admission blood glucose is an independent predictive factor for hospital mortality in polytraumatised patients Received: 3 September 2008 Accepted: 6 February 2009 Published online: 24 February 2009 Ó Springer-Verlag 2009 J. Kreutziger ( ) ) Á V. Wenzel Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria e-mail: janett.kreutziger@uki.at Tel.: ?43-512-50480357 Fax: ?43-512-5046780357 A. Kurz Department of Anaesthesiology, The Cleveland Clinic, Cleveland, OH, USA M. A. Constantinescu Department of Plastic, Reconstructive and Hand Surgery, Inselspital, University Hospital, Berne, Switzerland Abstract Purpose: The goal of this study was to analyse a possible association of admission blood glu- cose with hospital mortality of polytraumatised patients and to develop an outcome prediction model for this patient group. Methods: The outcome of adult polytraumatised patients admitted to the University Hospital of Berne, Switzerland, between 2002 and 2004 with an ISS C 17, and more than one severely injured organ system was retrospectively analysed. Results: The inclusion criteria were met by 555 patients, of which 108 (19.5%) died. Hyperglycaemia proved to be an independent predictor for hospital mortality (P \ 0.0001), following multiple regression analysis. After inclusion of admission blood glucose, the calculated mortality prediction model performed better than currently described models (P \ 0.0001, AUC 0.924). Conclusion: In this retro- spective, single-centre study in polytraumatised patients, admission blood glucose proved to be an inde- pendent predictor of hospital mortality following regression analy- sis controlling for age, gender, injury severity and other laboratory param- eters. A reliable admission blood glucose-based mortality prediction model for polytraumatised patients could be established. This observation may be helpful in improving the precision of future outcome predic- tion models for polytraumatised patients. These observations warrant further prospective evaluation. Keywords Severely injured patients Á Polytrauma Á Blood glucose Á Hyperglycaemia Á Outcome Introduction Trauma is still the leading cause of death in young adults and a major cause of morbidity and mortality at all ages. Recent outcome observations directed the focus on the impact of hyperglycaemia in trauma patients [1–3], par- ticularly in patients with traumatic brain injury [4, 5]. Hyperglycaemia is also associated with poor outcome in critically ill patients [6]. Various trauma scores for outcome prediction have been described, but none of them incorporates blood glucose. Since blood glucose could be an individual surrogate parameter for stress, it may harbour the poten- tial for improvement of the predictive value of current trauma scores. The current study was designed to retrospectively investigate the association of admission blood glucose on the outcome in polytraumatised patients, as measured by hospital mortality. The second goal was to develop a predictive outcome model of admission blood glucose for outcome in this particular patient population. Our hypothesis was that admission blood glucose may be helpful in the determination of outcome in polytrauma- tised patients. Intensive Care Med (2009) 35:1234–1239 DOI 10.1007/s00134-009-1446-z ORIGINAL