Prognostic Value of Admission Blood Glucose in Diabetic and Non-diabetic Patients with Intracerebral Hemorrhage.

Shichao Sun,Li Guo,Xingquan Zhao,Yongjun Wang,Liping Liu,Yuesong Pan,Yilong Wang,Yan He,Hao Li

doi:10.1038/srep32342

Abstract

We aimed to validate prognostic value of elevated admission blood glucose (ABG) for clinical outcomes in diabetic and non-diabetic patients with intracerebral hemorrhage (ICH) in a representative large cohort. Data of ICH patients with onset time ≤24 h were derived from the China National Stroke Registry. Clinical outcomes included 3-month poor outcome (death or dependency) and death. Logistic regression was performed for the association between ABG and clinical outcomes, both in the entire cohort and in patients with and without diabetes mellitus. 2951 ICH patients were enrolled, including 267 (9.0%) diabetics. In the entire cohort, there was a trend to increased risk of poor outcome with increasing ABG levels (adjusted OR 1.09; 95% CI, 1.04–1.15; P < 0.001). The risk of poor outcome was significantly greatest for the highest quartile (≥7.53 mmol/L) of ABG (adjusted OR 1.54; 95% CI, 1.17–2.03; p = 0.002, P for trend 0.004). We got similar association in non-diabetics but not in diabetics. Elevated ABG confers a higher risk of poor outcome in non-diabetics than diabetics with similar glucose level. Elevated ABG is an independent predictor of 3-month poor outcome in ICH patients, the prognostic value of which is greater in non-diabetics than diabetics with similar glucose level.

Highlights

Intracerebral hemorrhage (ICH) accounts for 10–15% of all stroke cases in Western countries and up to 20% to 30% in Asian countries[1], which is associated with higher rates of death and disability than ischemic stroke[2]
It is important to determine whether elevated admission blood glucose (ABG) after intracerebral hemorrhage (ICH) is associated with increased poor outcome, since this factor may be therapeutically modified
Our study indicates that elevated ABG is an independent predictor of 3-month poor outcome in ICH patients, the prognostic utility of which might be altered by patients’ diabetic status

Summary

Introduction

Intracerebral hemorrhage (ICH) accounts for 10–15% of all stroke cases in Western countries and up to 20% to 30% in Asian countries[1], which is associated with higher rates of death and disability than ischemic stroke[2]. The evaluation and control of predictors for ICH clinical outcomes is of great importance. The prognostic value of elevated ABG for ICH outcomes is still under debate and it is unclear whether elevated ABG portended a different prediction based on patients’ diabetic status. Some[5,6] but not all[7,8] studies have shown that elevated ABG is a predictor of poor outcomes in ICH, most of which are limited to small size, single-centre design, or no direct comparison between diabetics and non-diabetics. The purpose of this study is to validate the prognostic value of elevated ABG for clinical outcomes in diabetic and non-diabetic patients with intracerebral hemorrhage (ICH) in a representative large cohort

Objectives

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Results

Conclusion