Association of blood glucose with 30-day mortality in patients with intracerebral hemorrhage undergoing neurosurgical treatment

Abstract

Objective Published studies have shown hyperglycemia is associated with poor outcome in patients with intracerebral hemorrhage (ICH). However, the association between blood glucose and outcome in surgical ICH patients is unknown. In the present study, we sought to evaluate the predictive value of admission and postoperative glucose for 30-day outcome in patients with ICH undergoing neurosurgical treatment. Methods We retrospectively studied acute ICH patients who underwent neurosurgical treatment at a tertiary care hospital between January 2013 and December 2018. Patient demographics, clinical and radiological data were recorded. Serum glucose was measured at admission and after surgery. Receiver operating characteristic curves were used to evaluate the predictive power of important predictors. Multivariable logistic regression analyses were performed to identify independent factors of 30-day mortality. Results The present analysis included 344 patients (66.3% male, mean age 59.1 years). Elevated admission glucose (odds ratio [OR] 1.11; 95% confidence interval [CI] 1.03–1.20; p = .007) and postoperative glucose (OR 1.18, 95% CI 1.06–1.31; p = .003) were independently associated with increased 30-day mortality. There was no significant difference in predictive ability between admission glucose (area under curve [AUC] 0.668, 95% CI 0.608–0.719) and postoperative glucose (AUC 0.631, 95% CI 0.573–0.687) for 30-day death (p = .467). Multivariate logistic regression analysis also identified that admission Glasgow Coma Scale (GCS) score (p < .001), initial hematoma volume (p = .001), and the presence of intraventricular hemorrhage (IVH, p = .002) were independently predicted 30-day mortality. Conclusions For patients with ICH who received neurosurgical treatment, admission GCS score, initial hematoma volume, presence of IVH, admission and postoperative glucose level are independently associated with 30-day mortality. Admission and postoperative glucose may apply as predictors and targets for surgical ICH patients.