Hyperglycemia independently increases the risk of early death in acute spontaneous intracerebral hemorrhage.
BACKGROUND
It is unclear whether hyperglycemia on admission in patients with acute intracerebral hemorrhage (ICH) increases the risk of early death.


METHODS
100 consecutive patients (median age, 67.8 years) with acute supratentorial ICH within 24 h of onset were prospectively enrolled. Clinical characteristics and plasma glucose were assessed in all patients. ICH volume was measured on admission CT (<24 h) and follow-up CT (<48 h) scans. Patients were divided into two groups: the death group, who died within 14 days of onset, and the survival group. The association between early death and clinical characteristics were investigated by multivariate logistic regression analysis.


RESULTS
The death group consisted of 11 patients (median age, 77 years), while the survival group consisted of 89 patients (median age, 67 years). The admission plasma glucose level and the ICH volume were higher in the death group than in the survival group (glucose: death, 205 mg/dl vs. survival, 131 mg/dl, p<0.0001; and ICH volume: survival, 13.6+/-15.3 ml vs. death 101.1+/-48.7 ml, p<0.0001). Using receiver operating characteristic (ROC) curve, cut-off values that predicted early death were 150 mg/dl for the glucose level and >20 ml for the initial IVH volume. On multivariate logistic regression analysis, admission plasma glucose level>150 mg/dl (OR 37.5, CI 1.4-992.7, p=0.03) and IVH volume>20 ml (OR 64.6, CI 1.3-3173.5, p=0.04) were independent factors associated with early death.


CONCLUSIONS
Admission hyperglycemia may independently increase the risk of early death in acute spontaneous intracerebral hemorrhage.
Kimura
Kazumi
K
Department of Stroke Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki-city, Okayama, 701-0192, Japan. kimurak@med.kawasaki-m.ac.jp
Iguchi
Yasuyuki
Y
Inoue
Takeshi
T
Shibazaki
Kensaku
K
Matsumoto
Noriko
N
Kobayashi
Kazuto
K
Yamashita
Shinji
S
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001786:Blood Glucose / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D001929:Brain Edema / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D015897:Comorbidity; D048909:Diabetes Complications / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
D015415:Biomarkers; D001786:Blood Glucose; D005947:Glucose