Abstract 2900: Fasting Glucose On 14 Day After Onset predicts One-year poor Outcome In Aneurysmal Subarachnoid Hemorrhage

Abstract

Background and purpose: Admission hyperglycemia is associated with 3-month and/or 6-month poor outcomes after aneurysmal subarachnoid hemorrhage, but the effect of prolonged hyperglycemia on long-term outcomes is not very clear. We studied the relationship between 14 th day fasting glucose and 1-year outcome after aneurysmal subarachnoid hemorrhage. Methods: A prospective study of aneurysmal subarachnoid hemorrhage from August 2007 to August 2010 was used to analyze the effect of fasting glucose on admission and 14 th day respectively on 1-year outcome assessed with the modified Rankin scale. Onset to admission longer than 14 days were excluded from analysis, as well as patients died within the first 14 days post-onset. A total of 322 patients (female 54.7%, average age: 53.9±11.6 yr, 310 patients admitted within 7 days) were used to assess the relationship between poor outcomes and fasting glucose, and medical history, Fisher scale, Hunt and Hess grade, Glasgow Coma Scores. Poor outcome (death and dependency) was defined as modified Rankin scale 3-6 at 1 year. Multivariate Cox regression analysis was performed to assess risk factors for 1-year outcome. Results: The mean fasting glucose on 14 th day of poor outcome patients was higher than that of good outcome patients [(7.11±3.35) vs. (5.43±1.55) mmol/L, p <0.001]. Fasting glucose at admission in poor outcome patients was also higher than that of good outcome ones[(6.90±2.61) vs. (5.92±1.74) mmol/L, p =0.005]. After adjusting for Hunt and Hess grade, history of hypertension and Fisher scale, fasting glucose on 14 th day was an independent predictor of poor outcome (odds ratio, 1.278; 95% CI, 1.098 to 1.487; P =0.0016). Meanwhile, glucose level on 14 th day was found to be associated with 1-year death (adjusted HR, 1.183; 95%CI, 1.087 to 1.288) after adjusting for Fisher scale, Glasgow Coma Scale and treatment methods. However, fasting glucose at admission wasn’t independent predictor of 1-year death and dependency in Logistic regression and death in Cox regression. Conclusions: After aneurysmal subarachnoid hemorrhage, the fasting glucose levels on 14 th day are associated with an increased risk of 1-year death and dependency. Further studies are needed to confirm these results.