title: Emergency Department hyperglycemia as a predictor of early mortality and worse functional outcome after intracerebral hemorrhage.
abstract: BACKGROUND
  We have previously reported the association of hyperglycemia and mortality after ischemic stroke. This study attempts to answer the hypothesis, if hyperglycemia at arrival, is associated with early mortality and functional outcome in patients with acute non-traumatic intracerebral hemorrhage (ICH).
  
  
  METHODS
  The study cohort consisted of 237 patients who presented to the ED with ICH and had blood glucose measured on ED presentation. The presence of hyperglycemia on presentation was correlated with outcome measures including volume of hematoma, intraventricular extension of hematoma (IVE), stroke severity, functional outcome at discharge, and date of death.
  
  
  RESULTS
  Of the cohort of 237 patients, a total of 47 patients had prior history of Diabetes Mellitus (DM). Median blood glucose at presentation was 140 mg/dl (Inter-quartile range 112-181 mg/dl). DM patients had higher glucose levels on arrival (median 202 mg/dl for DM vs. 132.5 mg/dl for non-DM, P < 0.0001). Higher blood glucose at ED arrival was associated with early mortality in both non-diabetics and diabetics (P < 0.0001). Higher blood glucose was associated with poor functional outcome in non-DM patients(P < 0.0001) but not in DM patients (P = 0.268). In the logistic regression model, after adjustment for stroke severity, hematoma volume, and IVE of hemorrhage, higher initial blood glucose was a significant predictor of death (P = 0.0031); as well as bad outcome in non-DM patients (P = 0.004).
  
  
  CONCLUSIONS
  Hyperglycemia on presentation in non-diabetic patients is an independent predictor of early mortality and worse functional outcome in patients with intracerebral hemorrhage.
authors.affiliation: Department of Emergency Medicine, Mayo Clinic, College of Medicine, Rochester, MN, USA. stead.latha@mayo.edu
authors.forename: Latha G
authors.initials: LG
authors.lastname: Stead
authors.forename: Anunaya
authors.initials: A
authors.lastname: Jain
authors.forename: M Fernanda
authors.initials: MF
authors.lastname: Bellolio
authors.forename: Adetolu
authors.initials: A
authors.lastname: Odufuye
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Gilmore
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rabinstein
authors.forename: Raghav
authors.initials: R
authors.lastname: Chandra
authors.forename: Ravneet
authors.initials: R
authors.lastname: Dhillon
authors.forename: Veena
authors.initials: V
authors.lastname: Manivannan
authors.forename: Luis A
authors.initials: LA
authors.lastname: Serrano
authors.forename: Neeraja
authors.initials: N
authors.lastname: Yerragondu
authors.forename: Balavani
authors.initials: B
authors.lastname: Palamari
authors.forename: Minal
authors.initials: M
authors.lastname: Jain
authors.forename: Wyatt W
authors.initials: WW
authors.lastname: Decker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D002543:Cerebral Hemorrhage / Q000097:blood / Q000150:complications* / Q000401:mortality*; D015331:Cohort Studies; D048909:Diabetes Complications / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012372:ROC Curve; D016414:Resuscitation Orders; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
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