In this post-hoc analysis of the Intracerebral Hemorrhage (ICH) Deferoxamine Trial, we evaluated whether acute hyperglycemia following ICH is associated with cognitive impairment (CI).

In univariable tests, we compared baseline characteristics, ICH volumes, and presence of admission hyperglycemia (glucose ≥ 140 mg/dL) among patients with and without CI. In addition to hyperglycemia and baseline CI, variables with significant differences (p < 0.1) were included in a multivariable logistic regression model to determine predictors of CI.

Based on 205 available MoCA results (median score 24 [IQR 18–27]) from 294 patients in i-DEF, 134 (65%) patients had CI. Compared to cognitively normal patients, CI patients were older (61±12 vs. 57±11 years, p = 0.02), were more likely to be female (46% vs. 28%, p = 0.02), had lower rates of coronary disease (6% vs. 16%, p = 0.06), had higher rates of hyperglycemia (50% vs 34%, p = 0.03), and had higher ICH volumes (19.5 mL [IQR 9.3–32.7] vs. 12.2 mL [IQR 6.1–18.3], p < 0.01). When these variables were entered into the regression model, age (aOR 1.04, 95% CI [1.01–1.07]), hyperglycemia (aOR 2.01, 95% CI [1.02–3.95]), and ICH volume (aOR 1.03, 95% CI [1.01–1.06]) were independently associated with CI. Among the individual MoCA components, hyperglycemia was associated with lower visuospatial, naming, subtraction, and delayed recall scores (all p < 0.05).

The association of acute hyperglycemia and CI suggests that CI may be a modifiable therapeutic target for immediate clinical translation. Further studies are needed to clarify the mechanisms whereby excess glucose impacts specific cognitive domains.