Is diabetes a predictor of worse outcome for spontaneous intracerebral hemorrhage?

Wang, Qiuxiao; Wang, Deren; Liu, Ming; Yuan, Fang; You, Chao; Dong, Wei; Chang, Xueli; Lei, Chunyan; Zhang, Junhuai; Chen, Yanchao

doi:10.1016/j.clineuro.2015.01.020

Cited by 18 publications

(21 citation statements)

References 37 publications

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“…In our study diabetes was a risk factor for death in hemorrhagic stroke, in contrast to the study of Wang et al [35]. They suggested that diabetes in Han Chinese patients with hemorrhagic stroke was not associated with increased mortality or functional outcome.…”

Section: Discussioncontrasting

confidence: 98%

Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke

Snarska¹,

Bachórzewska−Gajewska²,

Kapica-Topczewska³

et al. 2017

aoms

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IntroductionStroke is the second leading cause of long-term disability and death worldwide. Diabetes and hyperglycemia may impact the outcome of stroke. We examined the impact of hyperglycemia and diabetes on in-hospital death among ischemic and hemorrhagic stroke patients.Material and methodsData from 766 consecutive patients with ischemic (83.15%) and hemorrhagic stroke were analyzed. Patients were classified into four groups: ischemic and diabetic; ischemic and non-diabetic; hemorrhagic and diabetic; and hemorrhagic and non-diabetic. Serum glucose was measured on admission at the emergency department together with biochemical and clinical parameters.ResultsMean admission glucose in ischemic stroke patients with diabetes was higher than in non-diabetic ones (p < 0.001) and in hemorrhagic stroke patients with diabetes than in those without diabetes (p < 0.05). Mean admission glucose in all patients who died was significantly higher than in patients who survived. In multivariate analysis, the risk factors for outcome in patients with ischemic stroke and without diabetes were age, admission glucose level and estimated glomerular filtration rate (eGFR), while in diabetics they were female gender, admission glucose level, and eGFR; in patients with hemorrhagic stroke and without diabetes they were age and admission glucose levels. The cut-off value in predicting death in patients with ischemic stroke and without diabetes was above 113.5 mg/dl, while in diabetics it was above 210.5 mg/dl.ConclusionsHyperglycemia on admission is associated with worsened clinical outcome and increased risk of in-hospital death in ischemic and hemorrhagic stroke patients. Diabetes increased the risk of in-hospital death in hemorrhagic stroke patients, but not in ischemic ones.

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Section: Discussioncontrasting

confidence: 98%

Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke

Snarska¹,

Bachórzewska−Gajewska²,

Kapica-Topczewska³

et al. 2017

aoms

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“…Although presence of DM was not related to outcome in our study, as it was in a larger Chinese population study [29], hyperglycemia was partly regarded as a manifestation of premorbid diabetic glucose metabolism [18] and diabetes status was found to independently influence the prognosis of patients after ICH in some reports [15]. Therefore, stratification statistical analysis was performed in our study.…”

Section: Discussionmentioning

confidence: 65%

Effect of Admission Hyperglycemia on 6-Month Functional Outcome in Patients with Spontaneous Cerebellar Hemorrhage

Tao

Wang

et al. 2017

Med Sci Monit

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BackgroundCerebellar hemorrhage (CH) has a quite different treatment strategy and prognostic factors compared with supratentorial intracerebral hemorrhage (ICH). The prognostic role of hyperglycemia has been discussed mainly in cases of supratentorial hemorrhage; it remains to be elucidated following CH. We aimed to determine the association of hyperglycemia on admission with 6-month functional outcome in CH patients.Material/MethodsWe retrospectively analyzed 77 patients with acute CH between September 2010 and April 2015 in West China Hospital. Blood glucose level was measured when the patients were admitted. Primary outcome was 6-month functional outcome, which could comprehensively reflect the patient’s recovery of physical and social ability after stroke and was assessed by the modified Rankin scale (mRS). Association of hyperglycemia with functional outcome was identified in logistic regression models.ResultsThere were 50 (64.9%) patients with poor functional outcomes. Patients with poor outcome were much older (P<0.001) and had a significantly higher glucose level on admission (P<0.001), a lower Glasgow Coma Scale score (P<0.001), a larger hematoma (P=0.003), and a higher incidence of intraventricular extension (P=0.002), brainstem compression (P=0.013), and hydrocephalus (P=0.023). Multivariate analysis showed that hyperglycemia (OR 1.50, 95% CI 1.07–2.08, P=0.017 when glucose level was analyzed as a continuous variable; OR 7.46, 95% CI 1.41–39.51, P=0.018 when glucose level was dichotomized by the critical threshold of 6.78 mmol/L) emerged as an independent predictor for adverse functional outcome at 6 months.ConclusionsTo the best of our knowledge, this is the first study focusing on the relationship between hyperglycemia and long-term functional outcome after CH. The study combined with previous pertinent reports definitely indicates the poor effect of hyperglycemia on both supra- and infratentorial ICH independent of hemorrhage site. Therefore, further controlled trials are urgently needed to evaluate the benefits of glucose-lowing treatment.

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“…The relationship between diabetes and neurological outcome is summarized in Table . Six studies showed an association between diabetes and poorer neurological outcome, whereas four studies did not show a difference. Between these studies, the outcome measures used were the modified Rankin scale (mRS), Functional Independence Measure and the Scandinavian stroke scale.…”

Section: Resultsmentioning

confidence: 86%

“…Geographically, the mean prevalence of diabetes in stroke inpatients was highest in Southeast Asian (Singapore, India, Indonesia) and East Asian countries (China, Japan, Taiwan), which were 33.5 and 32.3%, respectively, and mostly in Taiwan. The mean prevalence in studies from North America and Europe was 27.5 and 26.4%, respectively.…”

Section: Resultsmentioning

confidence: 96%

See 1 more Smart Citation

Prevalence of diabetes and its effects on stroke outcomes: A meta‐analysis and literature review

Lau

Lew

Borschmann

et al. 2018

J of Diabetes Invest

299

205

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Is diabetes a predictor of worse outcome for spontaneous intracerebral hemorrhage?

Cited by 18 publications

References 37 publications

Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke

Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke

Effect of Admission Hyperglycemia on 6-Month Functional Outcome in Patients with Spontaneous Cerebellar Hemorrhage

Prevalence of diabetes and its effects on stroke outcomes: A meta‐analysis and literature review

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