HUBUNGAN KADAR GULA DARAH DENGAN OUTCOME CEDERA KEPALA TERTUTUP DERAJAT SEDANG – BERAT DENGAN GAMBARAN BRAIN CT SCAN DALAM BATAS NORMAL

Abstract

Background : There is a lot of metabolic changes occurred in close head injury , it depends on the severity of injury , age , sex, and nutritional state before the injury. Hyperglicemi is one of the stress response after head injury.The aim of this study are to prove that there are increasing blood glucose level and is there any correlation with the outcome of the patients. Method : We performed a prognostic study with a cohort design. Subject of the study was moderate and severe close head injury patients with normal Ct scan during 14 days hospitalization.We obtained blood glucose level, fasting and 2 hours post prandial blood glucose level on first day of hospitalization and the next 14 days.We assessed neurological deficit based on the Disability Rating Scale (DRS). For Statistical Analysis we used Wilcoxon test to assess the differences between means of blood glucose level, fasting and 2 hours post prandial blood glucose level. Spearman Corelation test were calculated to explore the relationships between GCS, Blood glucose level on first day of hospitalization with DRS score on day 14. We used Reciprocal Operating Curve ( ROC ) analysis to established the cut off point. Results : The differences between means of blood glucose level and 2 hours post prandial blood glucose level on first day of hospitalization and the next 14 days with p value < 0,001. Blood glucose level, fasting and 2 hours post prandial blood glucose level on day 1 have a positive correlation with the DRS score on day 14 which increasing in blood glucose level will increase the DRS score with correlation coefficient 0,6 ; 0,6 ; 0,4 ; p value < 0,001 . Cut - off- point for blood glucose level was 127,0 mg/dl , fasting blood glucose level was 97,0 mg/dl, 2 hours post prandial blood glucose level was 122,5 mg/dl, with Area Under the Curve ( AUC ) Reciprocal Operating Curve ( ROC ) 0,001. Conclusion : There are strong correlation between glucose level with the DRS on day 14 of moderate and severe closed head injury with brain CT scan normally. Key words :Close head injury-Blood glucose level-Disability Rating Scale (DRS)