title: Severity of intraventricular extension correlates with level of admission glucose after intracerebral hemorrhage.
abstract: OBJECTIVE
  Hyperglycemia after spontaneous intracerebral hemorrhage (ICH) is associated with poor outcome, but the pathophysiology of ICH-induced glucose dysregulation remains unclear. We sought to identify clinical and radiographic parameters of ICH that are associated with admission hyperglycemia.
  
  
  METHODS
  Patients admitted to the Columbia University Medical Center Neurological Intensive Care Unit with spontaneous ICH between January 2009 and September 2010 were prospectively enrolled in the ICH Outcomes Project. Clinical, radiographic, and laboratory data were collected prospectively. Receiver operating characteristic analysis was used to identify the glucose level with optimal sensitivity and specificity for in-hospital mortality. Logistic and linear regression analyses were used to identify independent predictors of outcome measures where appropriate.
  
  
  RESULTS
  One hundred four patients admitted during the study period were included in the analysis. Mean admission glucose level was 8.23 ± 3.15 mmol/L (3.83 to 18.89 mmol/L) and 23.2% had a history of diabetes mellitus. Admission glucose was significantly associated with discharge (P=0.003) and 3-month mortality (P=0.002). Critical hyperglycemia defined at 10 mmol/L independently predicted discharge mortality (P=0.027; OR, 4.381; 95% CI, 1.186 to 16.174) and 3-month mortality (P=0.011; OR, 10.95; 95% CI, 1.886 to 62.41). Admission intraventricular extension score (P=0.038; OR, 1.117; 95% CI, 1.043 to 1.197) and diabetes mellitus (P=0.002; OR, 5.530; 95% CI, 1.833 to 16.689) were independent predictors of critical hyperglycemia. The intraventricular extension score (B=0.115, P=0.001) linearly correlated with admission glucose level (R=0.612, P=0.001) after adjusting for other clinical variables.
  
  
  CONCLUSIONS
  Admission hyperglycemia after spontaneous ICH is associated with poor outcome and potentially related to the presence and severity of intraventricular extension.
authors.affiliation: Department of Neurological Surgery, Columbia University, 710 West 168th Street, Room 431, New York, NY 10032, USA. ga2294@columbia.edu
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Appelboom
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Piazza
authors.forename: Brian Y
authors.initials: BY
authors.lastname: Hwang
authors.forename: Amanda
authors.initials: A
authors.lastname: Carpenter
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Bruce
authors.forename: Stephan
authors.initials: S
authors.lastname: Mayer
authors.forename: E Sander
authors.initials: ES
authors.lastname: Connolly
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000150:complications* / Q000175:diagnosis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D012306:Risk; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose