Masatoshi Koga1, Hiroshi Yamagami2, Satoshi Okuda3, Yasushi Okada4, Kazumi Kimura5, Yoshiaki Shiokawa6, Jyoji Nakagawara7, Eisuke Furui8, Yasuhiro Hasegawa9, Kazuomi Kario10, Shoji Arihiro11, Shoichiro Sato12, Kazunari Homma12, Takayuki Matsuki12, Naoto Kinoshita13, Kazuyuki Nagatsuka13, Kazuo Minematsu12, Kazunori Toyoda12. 1. Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address: koga@ncvc.go.jp. 2. Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology, Stroke Center, Kobe City General Hospital, Kobe, Japan. 3. Department of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan. 4. Department of Cerebrovascular Disease, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. 5. Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan. 6. Departments of Neurosurgery and Stroke Center, Kyorin University School of Medicine, Mitaka, Japan. 7. Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan. 8. Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan. 9. Department of Neurology, St Marianna University School of Medicine, Kawasaki, Japan. 10. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan. 11. Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan. 12. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. 13. Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.
Abstract
PURPOSE: Prognostic values of blood glucose levels following admission remain unclear. We investigated associations between blood glucose levels during the initial 72 h and outcomes of acute ICH. METHODS: Participants comprised hyperacute ICH patients who received intravenous antihypertensive treatment. Blood glucose levels were measured on admission and at 24 and 72 h after starting treatment, along with hemoglobin (Hb)A1c level on admission. Associations with clinical outcomes of hematoma expansion (>33% increase), none to minimal disability (3-month modified Rankin Scale [mRS] 0-1) and bedridden or death (3-month mRS 5-6) were analyzed. RESULTS: Of the 176 patients (70 women; 65 ± 12 years), 30 (18%) showed hematoma expansion, and 33 (19%) had none to minimal disability and 15 (10%) were bedridden or died. On multivariate regression analysis, blood glucose at 24h (per 10mg/dl odds ratio [OR], 0.84; 95% confidence interval [CI], 0.69-0.98) and blood glucose at 72 h (OR, 0.75; 95%CI, 0.59-0.92) were inversely associated with none to minimal disability, and blood glucose at 24h (OR, 1.14; 95%CI, 1.00-1.30) was positively associated with bedridden or death. No parameters were associated with hematoma expansion. CONCLUSIONS: High blood glucose levels at 24 and 72 h were independently associated with poor functional outcomes 3 months after ICH. We need to investigate whether blood glucose control during the acute period ameliorates clinical outcomes.
PURPOSE: Prognostic values of blood glucose levels following admission remain unclear. We investigated associations between blood glucose levels during the initial 72 h and outcomes of acute ICH. METHODS:Participants comprised hyperacute ICHpatients who received intravenous antihypertensive treatment. Blood glucose levels were measured on admission and at 24 and 72 h after starting treatment, along with hemoglobin (Hb)A1c level on admission. Associations with clinical outcomes of hematoma expansion (>33% increase), none to minimal disability (3-month modified Rankin Scale [mRS] 0-1) and bedridden or death (3-month mRS 5-6) were analyzed. RESULTS: Of the 176 patients (70 women; 65 ± 12 years), 30 (18%) showed hematoma expansion, and 33 (19%) had none to minimal disability and 15 (10%) were bedridden or died. On multivariate regression analysis, blood glucose at 24h (per 10mg/dl odds ratio [OR], 0.84; 95% confidence interval [CI], 0.69-0.98) and blood glucose at 72 h (OR, 0.75; 95%CI, 0.59-0.92) were inversely associated with none to minimal disability, and blood glucose at 24h (OR, 1.14; 95%CI, 1.00-1.30) was positively associated with bedridden or death. No parameters were associated with hematoma expansion. CONCLUSIONS: High blood glucose levels at 24 and 72 h were independently associated with poor functional outcomes 3 months after ICH. We need to investigate whether blood glucose control during the acute period ameliorates clinical outcomes.
Authors: Fan Zhang; Si Zhang; Chuanyuan Tao; Zijia Yang; Xi Li; Chao You; Tao Xin; Mu Yang Journal: Medicine (Baltimore) Date: 2019-03 Impact factor: 1.817
Authors: Teddy Y Wu; Jukka Putaala; Gagan Sharma; Daniel Strbian; Turgut Tatlisumak; Stephen M Davis; Atte Meretoja Journal: J Am Heart Assoc Date: 2017-08-02 Impact factor: 5.501