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Poster

Inpatient rehabilitation, blood glucose, and the outcome of TBI

Tuesday, October 31, 2023
3:25 PM – 3:31 PM  
Location: Station 9

    Presenting Author(s)

  • Shan-Pin Fanchiang, OTR/L, PhD. (she/her/hers)

    Clinical researcher and education specialist
    Rancho Los Amigos National Rehabilitation Center, Dept of Health Services, County of Los Angeles
    Downey, California, United States

    • Non-presenting Author(s)

  • AT

    Aidan Tan, MS

    Researcher
    Charles R. Drew University, California, United States

    • Presenting Author(s)

  • Mari Tobita, MD

    Physician Specialist
    Rancho Los Amigos National Rehabilitation Center
    Downey, California, United States

    • Non-presenting Author(s)

  • TF

    Theodore C. Friedman, MD, Ph.D.

    Chairman, Department of Internal Medicine; Chief, Division of Endocrinology
    Charles R Drew Univ of Med & Science, United States

  • BJ

    Barry Jordan, MD, MPH

    Chief Medical Officer
    Rancho Los Migos National Rehabilitation Center
    Downey, California, United States

Research Objectives: To explore if the blood glucose (BG) of patients with traumatic brain injury (TBI) measured at the admission of inpatient rehabilitation (A-IR) is related to the outcomes at the discharge of inpatient rehabilitation (DC-IR).

Design: A retrospective improvement study, with extracted data from the electronic medical records (EMR): the Glasgow Coma Scale (GCS) recorded at the admission to the emergency room, the BG and blood pressure measured at the A-IR, the demographic variables, and the Disability Rating Scale (DRS) which was retrospectively rated based on the summaries written at the DC-IR.

Setting: A public hospital specializing in inpatient rehabilitation.

Participants: Patients with TBI (N=278) admitted from 1/1/2018 to 12/31/2020 with the ICD-10 codes of TBI, with complicated mild and moderate/severe TBI, and were found to have the complete data in the EMR. Close to 50% of them were of Hispanic background and less than 10% were white.

Interventions: Not applicable.

Main Outcome Measures: The DRS, with a higher score, indicates a worse outcome.

Results: A stepwise regression yielded a significant and strong model to the DRS, R square: 0.242, p .000, F: 21.761 with df 3, 273. The significant independent variables included were GCS, age, rehabilitation length of stay (LOS), and the lowest level of the BG (i.e., < 110 mg/dL). This BG category has a negative impact on DRS and the inclusion of this variable underscores its unique influence on the outcome, DRS. A significant difference in DRS among the four levels of BG (i.e., < 110 mg/dL, >=110 and < 140 mg/dL, >=140 and < 180 mg/dL, and >=180 mg/dL) was found using the one-way ANOVA (p < .027, F: 3.117, df: 3). Patients with BG >= 110 mg/dL were found to have a worse outcome compared to those with BG < 110 mg/dL.

Conclusions: Together with GCS, age of TBI onset, and rehabilitation length of stay, the blood glucose < 110 mg/dL at the inpatient rehabilitation admission was found to significantly contribute to the discharge outcome of inpatient rehabilitation.

Author(s) Disclosures: None

Learning Objectives:

  • Distinguish how blood glucose of inpatients with TBI may be related to the outcome of inpatient physical rehabilitation.
  • Examine the potential implication of blood glucose less than 110 mg/dL among inpatients with TBI.
  • Recognize the age of TBI onset, the status of GCS, and the outcome among patients with TBI who attended inpatients physical rehabilitation.