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Severity of intraventricular extension correlates with level of admission glucose after intracerebral hemorrhage.
Stroke. 2011 Jul; 42(7):1883-8.S

Abstract

BACKGROUND AND PURPOSE

Hyperglycemia after spontaneous intracerebral hemorrhage (ICH) is associated with poor outcome, but the pathophysiology of ICH-induced glucose dysregulation remains unclear. We sought to identify clinical and radiographic parameters of ICH that are associated with admission hyperglycemia.

METHODS

Patients admitted to the Columbia University Medical Center Neurological Intensive Care Unit with spontaneous ICH between January 2009 and September 2010 were prospectively enrolled in the ICH Outcomes Project. Clinical, radiographic, and laboratory data were collected prospectively. Receiver operating characteristic analysis was used to identify the glucose level with optimal sensitivity and specificity for in-hospital mortality. Logistic and linear regression analyses were used to identify independent predictors of outcome measures where appropriate.

RESULTS

One hundred four patients admitted during the study period were included in the analysis. Mean admission glucose level was 8.23 ± 3.15 mmol/L (3.83 to 18.89 mmol/L) and 23.2% had a history of diabetes mellitus. Admission glucose was significantly associated with discharge (P=0.003) and 3-month mortality (P=0.002). Critical hyperglycemia defined at 10 mmol/L independently predicted discharge mortality (P=0.027; OR, 4.381; 95% CI, 1.186 to 16.174) and 3-month mortality (P=0.011; OR, 10.95; 95% CI, 1.886 to 62.41). Admission intraventricular extension score (P=0.038; OR, 1.117; 95% CI, 1.043 to 1.197) and diabetes mellitus (P=0.002; OR, 5.530; 95% CI, 1.833 to 16.689) were independent predictors of critical hyperglycemia. The intraventricular extension score (B=0.115, P=0.001) linearly correlated with admission glucose level (R=0.612, P=0.001) after adjusting for other clinical variables.

CONCLUSIONS

Admission hyperglycemia after spontaneous ICH is associated with poor outcome and potentially related to the presence and severity of intraventricular extension.

Authors+Show Affiliations

Department of Neurological Surgery, Columbia University, 710 West 168th Street, Room 431, New York, NY 10032, USA. ga2294@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21636822

Citation

Appelboom, Geoffrey, et al. "Severity of Intraventricular Extension Correlates With Level of Admission Glucose After Intracerebral Hemorrhage." Stroke, vol. 42, no. 7, 2011, pp. 1883-8.
Appelboom G, Piazza MA, Hwang BY, et al. Severity of intraventricular extension correlates with level of admission glucose after intracerebral hemorrhage. Stroke. 2011;42(7):1883-8.
Appelboom, G., Piazza, M. A., Hwang, B. Y., Carpenter, A., Bruce, S. S., Mayer, S., & Connolly, E. S. (2011). Severity of intraventricular extension correlates with level of admission glucose after intracerebral hemorrhage. Stroke, 42(7), 1883-8. https://doi.org/10.1161/STROKEAHA.110.608166
Appelboom G, et al. Severity of Intraventricular Extension Correlates With Level of Admission Glucose After Intracerebral Hemorrhage. Stroke. 2011;42(7):1883-8. PubMed PMID: 21636822.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severity of intraventricular extension correlates with level of admission glucose after intracerebral hemorrhage. AU - Appelboom,Geoffrey, AU - Piazza,Matthew A, AU - Hwang,Brian Y, AU - Carpenter,Amanda, AU - Bruce,Samuel S, AU - Mayer,Stephan, AU - Connolly,E Sander,Jr Y1 - 2011/06/02/ PY - 2011/6/4/entrez PY - 2011/6/4/pubmed PY - 2011/9/10/medline SP - 1883 EP - 8 JF - Stroke JO - Stroke VL - 42 IS - 7 N2 - BACKGROUND AND PURPOSE: Hyperglycemia after spontaneous intracerebral hemorrhage (ICH) is associated with poor outcome, but the pathophysiology of ICH-induced glucose dysregulation remains unclear. We sought to identify clinical and radiographic parameters of ICH that are associated with admission hyperglycemia. METHODS: Patients admitted to the Columbia University Medical Center Neurological Intensive Care Unit with spontaneous ICH between January 2009 and September 2010 were prospectively enrolled in the ICH Outcomes Project. Clinical, radiographic, and laboratory data were collected prospectively. Receiver operating characteristic analysis was used to identify the glucose level with optimal sensitivity and specificity for in-hospital mortality. Logistic and linear regression analyses were used to identify independent predictors of outcome measures where appropriate. RESULTS: One hundred four patients admitted during the study period were included in the analysis. Mean admission glucose level was 8.23 ± 3.15 mmol/L (3.83 to 18.89 mmol/L) and 23.2% had a history of diabetes mellitus. Admission glucose was significantly associated with discharge (P=0.003) and 3-month mortality (P=0.002). Critical hyperglycemia defined at 10 mmol/L independently predicted discharge mortality (P=0.027; OR, 4.381; 95% CI, 1.186 to 16.174) and 3-month mortality (P=0.011; OR, 10.95; 95% CI, 1.886 to 62.41). Admission intraventricular extension score (P=0.038; OR, 1.117; 95% CI, 1.043 to 1.197) and diabetes mellitus (P=0.002; OR, 5.530; 95% CI, 1.833 to 16.689) were independent predictors of critical hyperglycemia. The intraventricular extension score (B=0.115, P=0.001) linearly correlated with admission glucose level (R=0.612, P=0.001) after adjusting for other clinical variables. CONCLUSIONS: Admission hyperglycemia after spontaneous ICH is associated with poor outcome and potentially related to the presence and severity of intraventricular extension. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/21636822/full_citation/Severity_of_Intraventricular_Extension_Correlates_With_Level_of_Admission_Glucose_After_Intracerebral_Hemorrhage_ L2 - https://www.ahajournals.org/doi/10.1161/STROKEAHA.110.608166?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -