Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study

Fogelholm, R; Murros, Kari; Rissanen, Aimo; Avikainen, Sari

doi:10.1136/jnnp.2003.034819

Cited by 165 publications

(115 citation statements)

References 30 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…Another hospital-based study conducted in Italy [4], which included a consecutive series of 764 ICH patients over a 19 year period, concluded that hyperglycaemia (≥130 mg/dl) is a strong predictor of 30-day and 3-month mortality in non-diabetic, non-comatose supratentorial ICH patients. However, a retrospective study in a Finnish population [5] found no difference between admission glucose levels in non-diabetic ICH patients who died and those in diabetic ICH patients who survived. This study therefore concluded that hyperglycaemia is probably a stress response to neurological injury.…”

Section: Discussionmentioning

confidence: 90%

“…Experimental studies indicate that hyperglycaemia may increase brain oedema [12], inflammatory reaction [13], free radical injury [14] and excitotoxic or apoptotic cell death after stroke [15], but these results have not yet been demonstrated in humans to our knowledge. Although several studies have described possible effects of hyperglycaemia in ICH patients [4,5,[16][17][18][19][20][21], these studies used either small populations [5,16,17,19] or long enrolment periods [4]. Two small prospective studies [17,22] showed that hyperglycaemia is independently associated with shortterm mortality.…”

Section: Discussionmentioning

confidence: 99%

“…A prospective study conducted in a single Italian centre indicated that hyperglycaemia is an independent predictor of 3 day and 3 month mortality in non-diabetic, non-comatose patients after supratentorial intracerebral haemorrhage (ICH) [4]. In contrast, a population-based retrospective study conducted in Finland suggested that high admission blood glucose is the result of serious ICH [5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of glucose level on early and long-term mortality after intracerebral haemorrhage: the Acute Brain Bleeding Analysis Study

et al. 2009

View full text Add to dashboard Cite

Aims/hypothesis Admission hyperglycaemia is associated with a poor outcome in patients with ischaemic stroke. However, its prognostic effects after intracerebral haemorrhage (ICH) are still unclear. Methods We prospectively enrolled patients with ICH at 33 centres in Korea between October 2002 and March 2004. A total of 1,387 patients who had ICH and underwent brain computed tomography within 48 h of symptom onset were included in the study (n=1,387). Clinical information and radiological findings were collected at admission. Glucose levels were examined in relation to early (up to 30 days after ictus) and long-term (after 30 days) mortality rates using Cox regression analysis. To eliminate short-term effects, long-term mortality rate analysis was performed on surviving patients for more than 30 days. Results The long-term mortality rate was 21.1% after a mean follow-up of 434.3±223.2 days and was found to increase significantly with glucose quartile (p<0.001). Admission glucose level was an independent risk factor for early mortality (per mmol/l; adjusted HR 1.10 [95% CI 1.01-1.19]), but not for long-term mortality. Moreover, when analysis was restricted to patients without diabetes, glucose level was found to be an independent risk factor for post-ICH mortality (n=1,119; adjusted HR 1.10 [95% CI 1.03-1.17]) and had marginal significance for early (p= 0.053) and long-term mortality (p=0.09). Conclusions/interpretation We found that admission glucose levels were associated with early mortality after ICH. In patients without diabetes, admission glucose levels were associated with long-term mortality. We therefore suggest that intensive lowering of glucose level should be further investigated in ICH patients.

show abstract

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of glucose level on early and long-term mortality after intracerebral haemorrhage: the Acute Brain Bleeding Analysis Study

et al. 2009

View full text Add to dashboard Cite

show abstract

“…A large number of observational studies (21 studies, total number of patients=12 145, Table S6)2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32 have examined the association between glucose with ICH outcome with the majority (15 studies, total n=11 161) defining hyperglycemia on the basis of single glucose measurement. One notable study was the post hoc analysis of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) II study (n=2653) 30.…”

Section: Discussionmentioning

confidence: 99%

“…The recommendation was based on association of hyperglycemia and poor outcome in observational studies 2, 3, 4, 5. The major limitation of these studies is use of single glucose measurement not accounting for potential glucose fluctuations after ICH.…”

Section: Introductionmentioning

confidence: 99%

Persistent Hyperglycemia Is Associated With Increased Mortality After Intracerebral Hemorrhage

Putaala

Sharma

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundHyperglycemia may be associated with worse outcome after intracerebral hemorrhage (ICH). We assessed the association of early glycemic trajectory on ICH mortality and edema growth.Methods and ResultsWe included patients from the Helsinki ICH study with glucose measurements at least once between both 0 to 24 and 24 to 72 hours from onset. Hyperglycemia was defined as blood glucose ≥8 mmol/L (144 mg/dL) based on the local threshold for treatment. Glycemic trajectory was defined on maximum values 0 to 24 and 24 to 72 hours after ICH: (1) persistent normoglycemia in both epochs; (2) late hyperglycemia (only between 24 and 72 hours); (3) early hyperglycemia (only before 24 hours); and (4) persistent hyperglycemia in both epochs. Logistic regression with known predictors of outcome estimated the association of glycemic trajectory and 6‐month mortality. A generalized linear model assessed the association of glycemic trajectory and interpolated 72‐hour edema extension distance. A total of 576 patients met eligibility criteria, of whom 214 (37.2%) had persistent normoglycemia, 44 (7.6%) late hyperglycemia, 151 (26.2%) early hyperglycemia, and 167 (29.0%) persistent hyperglycemia. Six‐month mortality was higher in the persistent (51.1%) and early (26.3%) hyperglycemia groups than the normoglycemia (19.0%) and late hyperglycemia (3.6%) groups. Persistent hyperglycemia was associated with 6‐month mortality (odds ratio 3.675, 95% CI 1.989–6.792; P<0.001). Both univariate (P=0.426) and multivariable (P=0.493) generalized linear model analyses showed no association between glycemic trajectory and 72‐hour edema extension distance.ConclusionEarly hyperglycemia after ICH is harmful if it is persistent. Strategies to achieve glycemic control after ICH may influence patient outcome and need to be assessed in clinical trials.

show abstract

Predictors of Outcome in Warfarin-Related Intracerebral Hemorrhage

Zubkov¹,

Mandrekar²,

Claassen³

et al. 2008

Arch Neurol

112

View full text Add to dashboard Cite

show abstract

Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study

Cited by 165 publications

References 30 publications

Effects of glucose level on early and long-term mortality after intracerebral haemorrhage: the Acute Brain Bleeding Analysis Study

Effects of glucose level on early and long-term mortality after intracerebral haemorrhage: the Acute Brain Bleeding Analysis Study

Persistent Hyperglycemia Is Associated With Increased Mortality After Intracerebral Hemorrhage

Predictors of Outcome in Warfarin-Related Intracerebral Hemorrhage

Contact Info

Product

Resources

About