Prevalence of Diabetes Mellitus Among Patients With Subarachnoid Hemorrhage

Adams, Harold P.; Putman, S F; Kassell, Neal F.; Torner, James C.

doi:10.1001/archneur.1984.04050210031009

Cited by 64 publications

(36 citation statements)

References 16 publications

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“…44 Diabetes does not appear to be a risk factor for SAH. 47 Interestingly, some of the same risk factors for SAH also have been shown to increase the risk of multiple aneurysms (ie, smoking, female gender, hypertension, family history of cerebrovascular disease, and postmenopausal state). 48 -50 There has also long been interest in the influence of meteorological and temporal factors on the incidence of SAH.…”

Section: Risk Factors For Aneurysmal Sahmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Bederson¹,

Connolly²,

Batjer³

et al. 2009

Stroke

1,149

488

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Section: Risk Factors For Aneurysmal Sahmentioning

confidence: 99%

“…81,84,90 -95 Patients with multiple intracranial aneurysms may be particularly susceptible to new aneurysm formation. 47,93,96 It is not clear whether this is due to genetic or acquired factors.…”

Section: Risk Factors For Aneurysmal Sahmentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Bederson¹,

Connolly²,

Batjer³

et al. 2009

Stroke

1,149

488

View full text Add to dashboard Cite

“…Though history of diabetes mellitus is not frequently present in SAH patients, 61 its high pooled OR makes it interesting for further research as well. The predictive independency of history of diabetes mellitus additional to admission hyperglycemia was not analyzed in all studies, though diabetes mellitus was suggested to be independent of hyperglycemia in 1 study.…”

Section: January 2013mentioning

confidence: 99%

Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

Rooij

Rinkel

Dankbaar

et al. 2013

Stroke

164

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Background and Purpose— Established predictors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage are large amounts of extravasated blood and poor clinical condition on admission. The predictive value of other factors is uncertain. Methods— We searched MEDLINE (1960–2012) for clinical, laboratory, and radiological predictors routinely available within 72 hours after subarachnoid hemorrhage. The studies were categorized according to methodological quality. Crude data and effect estimates (odds ratio [OR], hazard ratios, and risk ratio) with 95% CI were extracted, (re-)calculated and pooled if possible. For every potential predictor we assessed all effect estimates on consistency (point estimates in equal direction) and clinical relevance (size and 95% CI). Results— Fifty-two studies on 33 potential predictors were included. There was strong evidence (≥3 high-quality studies) for a higher risk of delayed cerebral ischemia in smokers (pooled OR, 1.2; 95% CI, 1.1–1.4), and moderate evidence (2 high-quality studies) for an increased risk in patients with hyperglycemia (OR, 3.2; 1.8–5.8 and hazard ratios, 1.7; 1.1–2.5), hydrocephalus (OR, 1.3; 1.1–1.5 and OR, 2.6; 1.2–5.5), history of diabetes mellitus (pooled OR, 6.7; 1.7–26), and early systemic inflammatory response syndrome (pooled OR, 2.1; 1.4–3.3). Evidence was limited for increased risk in women (pooled OR, 1.3; 1.1–1.6) and in patients with history of hypertension (pooled OR, 1.5; 1.3–1.7). The evidence on initial loss of consciousness, history of migraine, previous use of selective serotonin reuptake inhibitors, hypomagnesemia, low hemoglobin, or high blood flow on early transcranial Doppler was also limited. Conclusions— There is strong evidence that smoking is a predictor of delayed cerebral ischemia. For several other potential predictions the evidence is moderate, limited, or inconsistent.

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“…In contrast to ischemic stroke, however, there appears to be no association between DM and the occurrence of aneurysmal SAH 4,55,56 ; likewise, the number of patients with unrecognized DM will be relatively low. Irrespective of its origin, high levels of glucose also could be causally linked with poor clinical outcome.…”

Section: Discussionmentioning

confidence: 92%

Hyperglycemia and Clinical Outcome in Aneurysmal Subarachnoid Hemorrhage

Kruyt

Biessels

Haan

et al. 2009

Stroke

105

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Background and Purpose-Hyperglycemia may worsen outcome after aneurysmal subarachnoid hemorrhage. We performed a systematic review to investigate the relation between admission hyperglycemia and outcome after aneurysmal subarachnoid hemorrhage. Methods-We included cohort studies or clinical trials of patients with aneurysmal subarachnoid hemorrhage admitted within 72 hours that documented admission glucose levels or the rate of hyperglycemia. Outcome had to be assessed prospectively after 3 or more months. The overall mean glucose level was calculated by weighting for the number of patients included in each study. To calculate the effect size, we pooled the ORs and 95% 95% CIs of poor clinical outcome in patients with or without hyperglycemia. Results-We searched MEDLINE, EMBASE, Science Citation Index, and the bibliographies of relevant studies. We included 17 studies totaling 4095 patients. The mean admission glucose level was 9.3 mmol/L (range, 7.4 to 10.9 mmol/L; 14 studies, 3373 patients) and the median proportion of patients with hyperglycemia was 69% (range, 29 to 100; 16 studies, 3995 patients; cutoff levels of hyperglycemia, 5.7 to 12.0 mmol/L). The pooled OR (8 studies, 2164 patients) for poor outcome associated with hyperglycemia was 3.1 (95% CI, 2.3 to 4.3). Cutoff points for defining hyperglycemia varied across studies (6.4 to 11.1 mmol/L), but this had no clear effect on the observed OR for poor outcome. Conclusions-After aneurysmal subarachnoid hemorrhage, admission glucose levels are often high and hyperglycemia is associated with an increased risk of poor clinical outcome. A randomized clinical trial is warranted to study the potential benefit of glycemic control after aneurysmal subarachnoid hemorrhage. (Stroke. 2009;40:e424-e430.)

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Prevalence of Diabetes Mellitus Among Patients With Subarachnoid Hemorrhage

Cited by 64 publications

References 16 publications

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

Hyperglycemia and Clinical Outcome in Aneurysmal Subarachnoid Hemorrhage

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