title: Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study.
abstract: BACKGROUND
  The role of admission blood glucose level on the prognosis of patients with intracerebral haemorrhage has not been elucidated.
  
  
  OBJECTIVE
  To examine this association on the basis of an epidemiologically representative patient material.
  
  
  METHODS
  249 500 people living in the catchment area of the Central Hospital of Central Finland. The diagnosis of ICH was established if verified by cranial computed tomography (CT) or autopsy.
  
  
  RESULTS
  Of the 416 patients who fulfilled the diagnostic criteria, 30 died before admission and 386 were admitted to the Central Hospital. All 329 patients (290 nondiabetics and 39 diabetics) with both admission blood glucose and cranial CT data were included in the study. The mean blood glucose level was 10.6 mmol/l for nondiabetics who died on the day of onset, 8.6 mmol/l for those dying during days 1 to 28, and 6.8 mmol/l for the 28 day survivors. The corresponding figures for diabetics were 13.9 mmol/l, 12.5 mmol/l, and 9.3 mmol/l. In both nondiabetics and diabetics, patients who died had significantly higher mean glucose than the 28 day survivors (p<0.0001 versus p = 0.029). However, blood glucose of the surviving diabetics was as high as that of the deceased nondiabetics (9.3 mmol/l versus 9.1 mmol/l). In nondiabetics, admission blood glucose was associated with parameters signifying severe stroke; disturbed consciousness, large haematoma volume and shift of cerebral midline structures, and high admission mean arterial pressure. In logistic regression analysis, high admission blood glucose in nondiabetics was a significant predictor of death during the first 28 days of onset (odds ratio 1.22, 95% CI 1.07 to 1.40).
  
  
  CONCLUSIONS
  High admission blood glucose predicts increased 28 day case fatality rate in both nondiabetic and diabetic patients with ICH. Because high admission blood glucose was associated with markers of severe stroke, we are inclined to support the stress theory; high admission blood glucose is the result of a serious ICH.
authors.affiliation: Pappilantie 10 B 8, 02400 Kirkkonummi, Finland. r.fogel@kolumbus.fi
authors.forename: R
authors.initials: R
authors.lastname: Fogelholm
authors.forename: K
authors.initials: K
authors.lastname: Murros
authors.forename: A
authors.initials: A
authors.lastname: Rissanen
authors.forename: S
authors.initials: S
authors.lastname: Avikainen
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000473:pathology*; D048909:Diabetes Complications / Q000401:mortality* / Q000473:pathology*; D016021:Epidemiologic Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis
chemical_list: D001786:Blood Glucose
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