Abstract Details

Title Admission Blood Glucose Predicts High Hematoma Volume in Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 229

Objective

Background BACKGROUND: Admission blood glucose (BG) is a predictor of poor outcome in patients with ICH. We tested the hypothesis that this may be due to an effect on hematoma volume (presumably from transient endothelial dysfunction).

Design/Methods DESIGN/METHODS: Records of patients with primary ICH from a community hospital and two teaching hospitals over 36 months were reviewed. Traumatic and subarachnoid hemorrhages were excluded. Patient demographics, history of diabetes, BG and modified rankin scale (mRS) at discharge were calculated. An mRS of 0- 2 was defined as good outcome and 3-6 was considered a poor outcome. Hematoma volume was calculated on the admission CT by using the formula of ABC/2.

Results RESULTS: The analysis included 168 patients (mean age 62±13 years;51.8% males). Of the patients, 23.8% had a prior history of diabetes and 33.9% presented with an admission BG>140 mg/dl. The mean ICH volume among patients with BG>140 mg/dl was 65±76.3 cm3 vs. 21.6±27.9 cm3 in those with BG<140 mg/dl (p<0.0010). A history of diabetes did not correlate with hematoma volume (p=0.19). Among those with a BG>140 mg/dl, 84.5% had a bad outcome compared to 63.6 % among those with BG<140 (p=0.004).In a logistic regression model patients with BG>140 mg/dl were three times more likely to have a poor outcome at discharge (OR 3.1;CI 1.4-6.9). Upon correcting for hematoma volume, admission blood glucose no longer correlated with discharge outcome (p=0.3), suggesting that the effect of high BG on outcome may be due to increased hematoma volumes.

Conclusions CONCLUSIONS: Acute elevation of blood glucose rather than a history of diabetes predicts higher hematoma volumes in ICH. Transient endothelial dysfunction needs to be evaluated as a potential mechanism mediating this association. Further analysis to study whether blood glucose control prevents hematoma expansion is warranted.

Authors/Disclosures
Carrie Kubiak PRESENTER	No disclosure on file
Wazim Mohamed, MD (Detroit Medical Center/Wayne State University)	Dr. Mohamed has nothing to disclose.
Pratik D. Bhattacharya, MD, MPH (International Medical Clinic)	Dr. Bhattacharya has a non-compensated relationship as a Research Advisor with Defeat MSA Alliance 501 (c) (3) that is relevant to AAN interests or activities.
Greg Mytyk (University of Tennessee)	No disclosure on file

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