Abstract Details

Title Admission Hyperglycemia Correlates with Hematoma Volume in Patients with Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 167

Objective

Background BACKGROUND: Admission hyperglycemia is commonly observed in patients with intracerebral hemorrhage (ICH). There is conflicting evidence whether hyperglycemia in ICH is a stress response or a direct cause of increased mortality and morbidity.

Design/Methods DESIGN/METHODS: We reviewed our spontaneous ICH database between January 2009 and June 2012. Patients were divided into two groups based on admission blood sugar (normoglycemia: blood sugar < 8mmol/L and hyperglycemia: blood sugar ? 8mmol/L). Using admission CT, hematoma volume was calculated by thin volumetric cuts using special software and expansion was defined as 33% increase in hematoma volume over 24 hours. We compared risk factors, clinical and laboratory parameters, and CT findings between the two groups using Fisher's exact test. A multivariate regression analysis was performed to identify factors correlating with admission hyperglycemia.

Results RESULTS: Out of 200 patients, 86 had admission hyperglycemia. Patient with hyperglycemia were more likely to have hypertension (85% vs. 69%, p=0.012), coronary artery disease (27% vs. 12%, p=0.01), diabetes (36% vs. 12%, p<0.001), larger hematoma volume (44 ± 38 vs. 21 ± 29, p<0.01), intraventricular extension (IVH) (72% vs. 35%, p<0.01), and hematoma expansion (23% vs. 8%, p=0.004). There was increased length of ICU stay (6 ± 6 vs. 4 ± 6, p=0.031), pneumonia (24% vs. 11%, p=0.068), deep venous thrombosis (5% vs. 0%, p=0.033), intubation (59% vs. 24%, p <0.001), and mortality (40% vs. 17%, p<0.001) in the hyperglycemic group. On regression analysis, hyperglycemia independently correlated with admission hematoma volume ? 60 cc (OR=2.5,CI: 1.0-6.4,p=0.05) and IVH (OR=2.5,CI: 1.1-5.6,p=0.03).

Conclusions CONCLUSIONS: In our cohort, admission hyperglycemia in intracerebral hemorrhage is likely a stress response correlating with the degree of brain injury depicted by hematoma volume and IVH. Larger studies are needed to confirm our findings.

Authors/Disclosures
Eugene Y. Achi, MD (Cleveland Clinic Abu Dhabi) PRESENTER	No disclosure on file
Archana Hinduja, MD	Dr. Hinduja has nothing to disclose.
Jamil R. Dibu, MD (Cleveland Clinic Abu Dhabi)	No disclosure on file
Anand V. Patel, MD (University of Texas Medical Branch)	Dr. Patel has nothing to disclose.
Fred D. Lublin, MD, FAAN (Icahn School of Medicine At Mount Sinai)	Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medimmune/Viela Bio/Horizon. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Receptos/Celgene/BMS. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Labcorp. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralight. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Entelexo. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avotres. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Lublin has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple entities. Dr. Lublin has stock in Avotres. Dr. Lublin has stock in Neuralight. The institution of Dr. Lublin has received research support from Brainstorm. The institution of Dr. Lublin has received research support from biogen. The institution of Dr. Lublin has received research support from NIH.
	No disclosure on file
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.

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