Influence of Admission Blood Glucose in Predicting Outcome in Patients With Spontaneous Intracerebral Hematoma

被引：16

作者：

Kongwad, Lakshman, I ^{[1
]}

Hegde, Ajay ^{[1
]}

Menon, Girish ^{[1
]}

Nair, Rajesh ^{[1
]}

机构：

[1] Manipal Acad Higher Educ, Dept Neurosurg, Kasturba Med Coll, Manipal, Karnataka, India

来源：

FRONTIERS IN NEUROLOGY | 2018年 / 9卷

关键词：

intracerebral hemorrhage; mRS; stroke; admission blood glucose; stroke outcome; SERUM GLUCOSE; INTRAVENTRICULAR HEMORRHAGE; STRESS HYPERGLYCEMIA; NONDIABETIC PATIENTS; DIABETES-MELLITUS; PROGNOSTIC VALUE; STROKE TRIAL; BRAIN-INJURY; RISK; DEATH;

D O I：

10.3389/fneur.2018.00725

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Aims: Hyperglycemia or elevated blood glucose levels have been associated with poor outcomes in patients with ischemic stroke yet control of hyperglycemia has not resulted in good outcomes. High admission blood glucose (ABG) values have been mitigated by other poor prognosticators like large hematoma volume, intraventricular extension (IVE) of hematoma and poor GCS. The aim of this study was to evaluate the effects of blood glucose levels at admission, on mortality and functional outcomes at discharge and 3 months follow up. Methods: This was a retrospective observational study conducted at a tertiary care. Patients with spontaneous SICH were enrolled from a prospective SICH register maintained at our hospital. Blood glucose values were recorded on admission. Patients with traumatic hematomas, vascular malformations, aneurysms, and coagulation abnormalities were excluded from our study. Results: A total of 510 patients were included in the study. We dichotomised our cohort into two groups, group A with ABG> 160 mg/dl and group B with ABG< 160 mg/dl. Mean blood glucose levels in these two groups were 220.73 mg/dl and 124.37 mg/dl respectively, with group A having twice the mortality. mRS at discharge and 3 months was better in Group B (p < 0.001) as compared to Group A. Age, GCS, volume of hematoma, ABG, IVE and Hydrocephalus were significant predictors of mortality and poor outcome on univariate analysis with a p < 0.05. The relationship between ABG and mortality (P = 0.249, 95% CI 0.948-1.006) and outcome (P = 0.538, 95% CI 0.997-1.005) failed to reach statistical significance on multivariate logistic regression. Age, Volume of hematoma and GCS were stronger predictors of mortality and morbidity. Conclusion: Admission blood glucose levels was not an independent predictor of mortality in our study when adjusted with age, GCS, and hematoma volume. The effect of high ABG on SICH outcome is probably multifactorial and warrants further research.

引用

页数：7

共 57 条

[1] Ariesen M.J., Claus S.P., Rinkel G.J.E., Algra A., Risk factors for intracerebral hemorrhage in the general population: a systematic review, Stroke, 34, pp. 2060-2065, (2003)
[2] Qureshi A.I., Mendelow A.D., Hanley D.F., Intracerebral haemorrhage, Lancet, 373, pp. 1632-1644, (2009)
[3] Bhalla A., Wang Y., Rudd A., Wolfe C.D.A., Differences in outcome and predictors between ischemic and intracerebral hemorrhage: the South London Stroke Register, Stroke, 44, pp. 2174-2181, (2013)
[4] Dennis M.S., Outcome after brain haemorrhage, Cerebrovasc Dis, 16, pp. 9-13, (2003)
[5] Mankovsky B.N., Metzger B.E., Molitch M.E., Biller J., Cerebrovascular disorders in patients with diabetes mellitus, J Diabetes Complicat, 10, pp. 228-242, (1996)
[6] Capes S.E., Hunt D., Malmberg K., Gerstein H.C., Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview, Lancet, 355, pp. 773-778, (2000)
[7] Bruno A., Levine S.R., Frankel M.R., Brott T.G., Lin Y., Tilley B.C., Et al., Admission glucose level and clinical outcomes in the NINDS rt-PA Stroke Trial, Neurology, 59, pp. 669-674, (2002)
[8] Capes S.E., Hunt D., Malmberg K., Pathak P., Gerstein H.C., Stress hyperglycemia and prognosis of stroke in non-diabetic and diabetic patients: A systematic overview, Stroke, 32, pp. 2426-2432, (2001)
[9] Tapia-Perez J.H., Gehring S., Zilke R., Schneider T., Effect of increased glucose levels on short-term outcome in hypertensive spontaneous intracerebral hemorrhage, Clin Neurol Neurosurg, 118, pp. 37-43, (2014)
[10] Passero S., Ciacci G., Ulivelli M., The influence of diabetes and hyperglycemia on clinical course after intracerebral hemorrhage, Neurology, 61, pp. 1351-1356, (2003)

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