Abstract Details

Title Diabetes Mellitus Can Modify Prognosis in Hypertensive Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 267

Objective

Background BACKGROUND: In patients with spontaneous hypertensive ICH large hematoma volume, intraventricular extension and infratentorial location have been implicated with poor prognosis. Acute hyperglycemia is also an indicator of disease severity and a predictor of poor outcome in intracerebral hemorrhage. The coexistence of diabetes mellitus and its relation to prognostic radiologic markers of outcome in spontaneous hypertensive ICH is not well understood.

Design/Methods DESIGN/METHODS: Case-control study of consecutive patients with first time spontaneous hypertensive ICH presenting between July 1, 2009 to June 30, 2011, to a tertiary care hospital in San Juan, Puerto Rico. Clinical, radiographical, and laboratory data were collected retrospectively. Hypertensive patients with spontaneous hypertensive intracerebral hemorrhage (ICH) and a diagnosis of diabetes mellitus were defined as cases and hypertensive patients from the same population with spontaneous hypertensive intracerebral hemorrhage (ICH) but without diabetes mellitus were controls. Data for hematoma volume, location and intraventricular extension was collected from the radiographic images. Hematoma volume was approximated using the ABC/2 calculation.

Results RESULTS: Twenty-eight patients and 53 controls were included in the analysis. The mean hematoma volume was mildly increased but not significantly different between patients and controls (10.39 ml v 6.98 ml; p=0.20). The odds ratio for coexistent diabetes mellitus and hematoma volume larger than 30 ml was 1.92 (90% CI, 0.25 to 14.9), for intraventricular extension was 2.12 (90% CI, 1.09 to 4.12) and for infratentorial location was 0.55 (90% CI, 0.22 to 1.37).

Conclusions CONCLUSIONS: Patients with spontaneous hypertensive ICH and coexistent diabetes mellitus have a significantly increased probability of intraventricular extension and a trend toward larger hematoma volumes. Coexistent diabetes mellitus can have a negative impact in the prognosis of spontaneous hypertensive ICH .

Authors/Disclosures
Jose A. Diaz Pimentel, MD PRESENTER	No disclosure on file
Peter Senior	The institution of Peter Senior has received research support from Novo Nordisk. Peter Senior has received personal compensation in the range of $10,000-$49,999 for serving as a Guidelines Chair with Diabetes Canada (reg charity). Peter Senior has a non-compensated relationship as a Investigator (post hoc adjudication of thyroid AEs in MS trials) with Sanofi that is relevant to AAN interests or activities.
Carlos A. Luciano, MD, FAAN (University of Puerto Rico School of Medicine)	Dr. Luciano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi-Genzyme. Dr. Luciano has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for SIMED. Dr. Luciano has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Vazquez-Irizarry Law Office. The institution of Dr. Luciano has received research support from National Institutes of Health. Dr. Luciano has received personal compensation in the range of $100,000-$499,999 for serving as a Professor and Chair with University of Puerto Rico.

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