ED Glucose and WBC Count as Predictors of Abnormal Head CT in Elderly TBI Patients (P05.204)

OBJECTIVE: To determine the cut- off values for ED glucose and WBC count that predicts abnormal head CT in elderly TBI patients (≥55 years). BACKGROUND: Lab values as predictors of abnormal head CT findings in TBI aren9t researched well. DESIGN/METHODS: This is an observational chart review of consecutive elderly patients (≥55 years) who came to the ED department of a tertiary care hospital in North Central Florida with a TBI.Outcome variable was any abnormality on head CT scan(extracalvarial swelling,fracture of skull,and/or intracranial bleeding).Predictors were alteration of consciousness(AOC),post-traumatic amnesia(PTA),loss of consciousness(LOC),seizure, and vomiting after TBI.ED glucose and WBC count levels were also predictors. RESULTS: The cohort included 424 patients.Positive AOC and PTA are individual predictors of abnormal head CT.Also, increased ED glucose and WBC are predictors of abnormal head CT. The glucose level was divided in 2 groups (≤130 mg/dl and >130 mg/dl), and WBC count was divided in 2 groups (≤14000/cu mm and >14000 cu/mm). After division, individuals with higher WBC and glucose values are associated with higher likelihood of getting abnormal head CT. Two separate logistic regression models were developed to see the predictive effects of higher WBC and higher Glucose values on getting abnormal head CTs in presence of AOC,PTA,and age. Higher glucose group(>130 mg/dl) is associated with higher chances of abnormal head CT(p=0.01, OR=2.19) when controlling for age, AOC and LOC. The same is true for higher WBC levels (p=0.0002, OR=8.43). In presence of AOC, PTA and glucose>130 m/d, 95% patients had abnormal head CT, while 100% patients with AOC,PTA,and WBC>14000/cu mm had abnormal head CT. CONCLUSIONS: In our cohort, in elderly TBI patients (≥55 years), the increased values of ED glucose (>130 mg/dl) and WBC count (>14000/cu mm) are highly predictive of abnormal head CT in presence of AOC and PTA, regardless of severity or mechanism of injury. Disclosure: Dr. Bodhit has nothing to disclose. Dr. Daneshvar has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Elie-Turenne has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Stead has nothing to disclose.