-Original-

Serum Glucose-To-Potassium Ratio as a Prognostic Predictor for Severe Traumatic Brain Injury

Ami Shibata¹, Fumihiro Matano², Nobuyuki Saito³, Yu Fujiki⁴, Hisashi Matsumoto³, Takayuki Mizunari⁵ and Akio Morita²

¹Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan
²Department of Neurological Surgery, Nippon Medical School Hospital, Tokyo, Japan
³Department of Emergency and Critical Care Medicine Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan
⁴Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
⁵Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

Background: Initial management of severe traumatic brain injury is important and includes treatment decision-making and prediction of prognosis. We examined whether biomarkers at admission could be useful prognostic predictors. We focused on electrolytes and blood glucose, which can be measured easily at any facility and for which results can be obtained promptly, before those of other biomarkers, such as D-dimer.
Methods: All trauma patients with head injuries treated at Chiba Hokusoh Hospital between 2014 and 2017 were investigated. Cases of multiple trauma accompanied by fatal trauma, hemorrhagic shock, or cardiopulmonary arrest, and pediatric cases, were excluded from this study. Blood gas data at the initial hospital visit were reviewed retrospectively. A poor outcome was defined as death during hospitalization or a vegetative state due to head injury. Factors related to poor outcomes were analyzed.
Results: Of the 185 male and 79 female patients studied, 34 had poor outcomes. Poor outcome was significantly correlated with potassium (P = 0.003), glucose (P < 0.001), and glucose-to-potassium ratio (P < 0.001) at arrival. The odds ratio was 4.079 for a glucose-to-potassium ratio of ≥50.
Conclusions: We evaluated blood gas data at the initial hospital visit, as these results can be obtained more quickly than those of other biomarkers assessed previously. Serum glucose-to-potassium ratio at admission may be a potential predictor of prognosis for severe traumatic brain injury.

J Nippon Med Sch 2021; 88: 342-346

Keywords
head injury, prognostic predictor, traumatic brain injury, glucose-to-potassium ratio

Correspondence to
Ami Shibata, MD, Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
068m1044@nms.ac.jp

Received, May 13, 2020
Accepted, September 11, 2020