Increased Short-Term Mortality in Patients with Spontaneous Intracerebral Hemorrhage and its Association with Admission Glucose Levels and Leukocytosis

Kim, Young‐Jin; Han, Myung‐Hoon; Kim, Choong-Hyun; Kim, Jae-Min; Cheong, Jin Hwan; Ryu, Je Il

doi:10.1016/j.wneu.2016.11.087

Cited by 19 publications

(19 citation statements)

References 41 publications

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“…Although no significant association was reported between baseline leukocyte count increase and mortality in some studies, [24,25,29,33] some other studies had the conflicting results. [27,28] The results of this meta-analysis suggested baseline leukocyte count increase was significantly associated with overall mortality and long-term morality, but not short-term mortality, which could be caused by the relatively small number of included studies and relatively high heterogeneity among these studies.…”

Section: Discussionmentioning

confidence: 99%

“…Several other studies discussed the association between baseline leukocytosis defined by cut-off values and mortality. Some of them reported the significant association between leukocytosis and mortality, [16,30,33] but some others showed the opposite results. [10,31] This meta-analysis suggested baseline leukocytosis defined by cut-off values had significant association with higher overall and short-term mortality, but did not reach significant association with long-term mortality, which could be caused by the small number of included studies and various cut-off values for leukocytosis in different studies.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic impact of leukocytosis in intracerebral hemorrhage

Zheng

Guo

et al. 2019

Medicine

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Background: Intracerebral hemorrhage (ICH) is correlated with high rate of death and poor outcome. Leukocytes participate in secondary brain injury in ICH. It is still not clear that whether leukocytosis can predict outcome in ICH. This study was performed to summarize that current evidences about the association between baseline leukocytosis and outcome in ICH patients in a systematic review and meta-analysis. Methods: Published studies were searched in 5 databases. Original studies about association between baseline leukocytosis and outcome in ICH were included. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were achieved to evaluate the association between leukocytosis and prognosis. Results: A total of 19 eligible studies with 6417 patients were analyzed in this study. Meta-analysis showed baseline leukocyte count increase was significantly associated with worse overall (OR = 1.13, 95% CI 1.05–1.21, P = .001), short-term (OR = 1.20, 95% CI 1.05–1.38, P = .009), and long-term functional outcome (OR = 1.12, 95% CI 1.04–1.20, P = .004). Baseline leukocytosis defined by cut-off values had significant association with worse overall functional outcome (OR = 1.95, 95% CI 1.01–3.76, P = .046). Baseline leukocyte count increase was significantly associated with higher overall (OR = 1.10, 95% CI 1.02–1.18, P = .011) and long-term mortality (OR = 1.12, 95% CI 1.03–1.22, P = .007). Baseline leukocytosis defined by cut-off values was significantly associated with higher overall (OR = 1.67, 95% CI 1.23–2.27, P = .001) and short-term mortality (OR = 1.74, 95% CI 1.12–2.70, P = .014). Conclusion: Baseline leukocytosis could be helpful in predicting prognosis in ICH patients. However, its prognostic value should be verified by further studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic impact of leukocytosis in intracerebral hemorrhage

Zheng

Guo

et al. 2019

Medicine

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“…However, this was not the case for white blood cell count. [24][25][26]28,44,45 In addition, higher serum lactate level and lower cholinesterase level on admission were associated with IHM. Cholinesterase, as a liver synthesis parameter, and serum lactate level, as an indicator for ischemia/hypoxia, could demonstrate cardiac and/or pulmonary dysfunction (e.g., right ventricular dysfunction or pulmonary hypertension with following congestion in the liver), which may additionally lead to poor functional outcome after ICH.…”

Section: Intrahospital Mortalitymentioning

confidence: 99%

Early Serum Biomarkers for Intensive Care Unit Treatment within the First 24 Hours in Patients with Intracerebral Hemorrhage

Bender

Naumann

Uhl

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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Background The prognostic significance of serum biomarkers in patients with intracerebral hemorrhage (ICH) is not well investigated concerning inhospital mortality (IHM) and cardiopulmonary events within the first 24 hours of intensive care unit (ICU) treatment. The influence of troponin I (TNI) value and cortisol value (CV) on cardiopulmonary events within the first 24 hours of ICU treatment was reported in subarachnoid hemorrhage patients, but not in ICH patients up to now. The aim of this study was to investigate the role of early serum biomarkers on IHM and TNI value and CV on cardiopulmonary events within the first 24 hours of ICU treatment. Patients and Methods A total of 329 patients with spontaneous ICH were retrospectively analyzed. Blood samples were taken on admission to measure serum biomarkers. The TNI value and CV were defined as biomarkers for cardiopulmonary stress. Demographic data, cardiopulmonary parameters, including norepinephrine application rate (NAR) in microgram per kilogram per minute and inspiratory oxygen fraction (FiO2) within the first 24 hours, and treatment regime were analyzed concerning their impact on ICU treatment and in hospital outcome. Binary logistic analysis was used to identify independent prognostic factors for IHM. Results Patients with initially nonelevated CVs required higher NAR (p = 0.01) and FiO2 (p = 0.046) within the first 24 hours of ICU treatment. Lower cholinesterase level (p = 0.004), higher NAR (p = 0.002), advanced age (p < 0.0001), larger ICH volume (p < 0.0001), presence of intraventricular hemorrhage (p = 0.007) and hydrocephalus (p = 0.009), raised level of C-reactive protein (p = 0.024), serum lactate (p = 0.003), and blood glucose (p = 0.05) on admission were significantly associated with IHM. In a multivariate model, age (odds ratio [OR]: 1.055; 95% confidence interval [CI]: 1.026–1.085; p < 0.0001), ICH volume (OR: 1.016; CI: 1.008–1.025; p < 0.0001), and Glasgow Coma Scale (GCS) score (OR: 0.680; CI: 0.605–0.764; p < 0.0001) on admission as well as requiring NAR (OR: 1.171; CI: 1.026–1.337; p = 0.02) and FiO2 (OR: 0.951; CI: 0.921–0.983, p = 0.003) within the first 24 hours were independent predictors of IHM. Conclusion Higher levels of C-reactive protein, serum lactate, blood glucose, and lower cholinesterase level on admission were significantly associated with IHM. Patients with initially nonelevated CVs required higher NAR and FiO2 within the first 24 hours of ICU treatment. Furthermore, requiring an NAR > 0.5 µg/kg/min or an FiO2 > 0.21 were identified as additional independent predictors for IHM. These results could be helpful to improve ICU treatment in ICH patients.

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“…Several and consistent studies demonstrate that BGC values at admission and during ICU/NCC stay have a strong predictive value on the clinical course and short-and long-term outcomes. [8][9][10][11][12][13][14][15][16][17][18][19][20] In NCC, evidence on optimal BGC target range and on the use of IIT has evolved over the course of past two decades and current information supports to maintain BGC values < 146 mg/dL with IIT. At the same time, the importance of adequate and timely delivered nutrition, either through PN or EN supply, is now confirmed, and to establish early and appropriate nutrition in patients with ABI caused by TBI has now been included among the suggested approaches in the guideline delivered by Brain Trauma Foundation with a level IIA evidence indication.…”

Section: Resultsmentioning

confidence: 99%

“…16 More recently, the relevance of BGC >136 mg/dL at NCC admission in patients with ICH was further confirmed in a retrospective data analysis of 538 cases in whom the 3-month mortality increased in a dose-dependent manner (hazard ratio: 1.004; per 1 mg/dL increase). 17 To conclude, the actual state-of-the-art evidence in literature supports that both hyperglycemia and hypoglycemia at NCC admission of adult and pediatric ABI patients (TBI, acute subarachnoid hemorrhage [aSAH], ICH, and AIS) correlate with higher morbidity (worse GOS, longer length of stay [LOS], etc.) and mortality.…”

Section: Introductionmentioning

confidence: 98%

Clinical Relevance of Blood Glucose Concentration and Hyperglycemia Management in Neurocritical Care Patients

Bilotta

Qeva

Prete

et al. 2019

Journal of Neuroanaesthesiology and Critical Care

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In patients admitted to a neurocritical care (NCC) unit, management of blood glucose concentration (BGC) is a challenging clinical task. Several studies have shown that episodes of hypo- and hyperglycemia and high BGC variability are associated with poor short- and long-term outcomes. Optimal BGC target-range and BGC management in NCC patients have dramatically evolved in the past decades and new insulin infusion and adequate nutrition protocols are now available. The aim of this narrative review is to report the state-of-the-art on clinical relevance on BGC and hyperglycemia management in NCC patients.

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Increased Short-Term Mortality in Patients with Spontaneous Intracerebral Hemorrhage and its Association with Admission Glucose Levels and Leukocytosis

Cited by 19 publications

References 41 publications

Prognostic impact of leukocytosis in intracerebral hemorrhage

Prognostic impact of leukocytosis in intracerebral hemorrhage

Early Serum Biomarkers for Intensive Care Unit Treatment within the First 24 Hours in Patients with Intracerebral Hemorrhage

Clinical Relevance of Blood Glucose Concentration and Hyperglycemia Management in Neurocritical Care Patients

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