title: Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis.
abstract: OBJECTIVE
  Admission hyperglycemia is associated with poor clinical outcome in ischemic and hemorrhagic stroke. Admission hyperglycemia has not been investigated in patients with cerebral venous thrombosis.
  
  
  METHODS
  Consecutive adult patients with cerebral venous thrombosis were included at the Academic Medical Center, The Netherlands (2000-2014) and the Helsinki University Central Hospital, Finland (1998-2014). We excluded patients with known diabetes mellitus and patients without known admission blood glucose. We defined admission hyperglycemia as blood glucose ≥7.8 mmol/L (141 mg/dL) and severe hyperglycemia as blood glucose ≥11.1 mmol/L (200 mg/dL). We used logistic regression analysis to determine if admission hyperglycemia was associated with modified Rankin Scale (mRS) score of 3 to 6 or mortality at last follow-up. We adjusted for: age, sex, coma, malignancy, infection, intracerebral hemorrhage, deep cerebral venous thrombosis, and location of recruitment.
  
  
  RESULTS
  Of 380 patients with cerebral venous thrombosis, 308 were eligible. Of these, 66 (21.4%) had admission hyperglycemia with 8 (2.6%) having severe admission hyperglycemia. Coma (31.3% versus 5.0%, P<0.001) and intracerebral hemorrhage (53.0% versus 32.6%, P=0.002) at presentation were more common among patients with admission hyperglycemia than normoglycemic patients. Patients with admission hyperglycemia had a higher risk of mRS score of 3 to 6 (adjusted odds ratio, 3.10; 95% confidence interval, 1.35-7.12) and mortality (adjusted odds ratio, 4.13; 95% confidence interval, 1.41-12.09). Severe hyperglycemia was even more strongly associated with mRS score of 3 to 6 (adjusted odds ratio, 11.59; 95% confidence interval, 1.74-77.30) and mortality (adjusted odds ratio, 33.36; 95% confidence interval, 3.87-287.28) compared with normoglycemic patients.
  
  
  CONCLUSIONS
  Admission hyperglycemia is a strong predictor of poor clinical outcome in patients with cerebral venous thrombosis.
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Susanna M
authors.initials: SM
authors.lastname: Zuurbier
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Sini
authors.initials: S
authors.lastname: Hiltunen
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Turgut
authors.initials: T
authors.lastname: Tatlisumak
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Guusje M
authors.initials: GM
authors.lastname: Peters
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Silvis
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Elena
authors.initials: E
authors.lastname: Haapaniemi
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Nyika D
authors.initials: ND
authors.lastname: Kruyt
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).
authors.forename: Jukka
authors.initials: J
authors.lastname: Putaala
authors.affiliation: From the Department of Neurology, Academic Medical Centre, Amsterdam, The Netherlands (S.M.Z., G.M.P., S.M.S, J.M.C.); Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands (N.D.K.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (S.H., T.T., E.H., J.P.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.). j.coutinho@amc.nl.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Coutinho
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D003128:Coma / Q000453:epidemiology*; D015897:Comorbidity; D056424:Decompressive Craniectomy; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007362:Intensive Care Units / Q000706:statistics & numerical data; D020767:Intracranial Thrombosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012851:Sinus Thrombosis, Intracranial / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D020246:Venous Thrombosis / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy
chemical_list: D000925:Anticoagulants; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: coma; diabetes mellitus; hyperglycemia; risk factors; sinus thrombosis, intracranial; stroke