Our early management of head-injured patients stresses avoidance and correction of SBIFs at all costs. Nonetheless, SBIFs occur frequently in the first 24 hours after traumatic brain injury. Six of the 11 factors studied are associated with significantly worse outcomes. Hypotension and hypothermia are independently related to mortality. Because these SBIFs are potentially preventable, protocols could be developed to decrease their frequency.

Early hyperglycemia is associated with poor outcomes for patients with severe traumatic brain injury. Tighter control of serum glucose without reduction of nutritional support may improve the prognosis for these critically ill patients.

Therapy, level III.

Epidemiological study, level III.