Contribution of early hyperglycemia and hypoalbuminemia to multiple organ dysfunction syndromes (mods) in multitrauma patients

Background: Recent randomized prospective data suggest that early hypoglycemia and hypoalbuminemia are associated with MODS in multitrauma patients. Objective: this study was to determine the contribution of early blood glucose elevation and decrease serum albumin in Trauma Emergency Department or ICU patients. Methods: We prospectively collected multitrauma patients with Injury Severity Score (ISS) ≥ 18, blood glucose, serum albumin, between 14 – 81 years old, admitted to level I Trauma Centre at Kandou General Hospital Manado for eleven months periods from September 2015 until July 2016. Sequential Organ Failure Assessment (SOFA) Score was used to determine MODS during hospitalization. Results: A total of 51 multitrauma patients were included in this study. The mean age was 31.73 years old, male 41(80.4%) and female 10(19.6%). Serum glucose level> 126 mg/dl occurred in 34 (66.7%) patientsand ≤ 126 mg/dl occurred in 17 (33.3%) patients. Serum albumin level ˂ 3,5 gr/dl occurred in 31 (60.8%) patients and ≥ 3,5 gr/dl occurred in 20 (39.2%) patients. Conclusion: Early hyperglycemia as defined by glucose >126mg/dl and hypoalbuminemia as defined by albumin <3,5gr/dl are associated with significantly higher MODS rates in multitrauma patients independent of injury characteristics. The present of early hyperglycemia and hypoalbuminemia may allow early identification of trauma patients who are at risk for MODS.