The deleterious effect of admission hyperglycemia on survival and functional outcome in patients with intracerebral hemorrhage

Abstract

Background and purpose: We aimed to evaluate the association between blood glucose (BG) levels at admission and both functional outcome at discharge and 1-month mortality after intracerebral hemorrhage (ICH).

Methods: All cases of first-ever ICH were identified from the population-based Stroke Registry of Dijon, France from 1985 to 2009. Clinical and radiological information was recorded. BG was measured at admission. Multivariate analyses were performed using logistic and Cox regression models. Multiple imputation was used as a sensitivity analysis.

Results: We recorded 465 first-ever ICH. BG at admission was obtained in 416 patients (89.5%) with a median value of 6.92 mmol/L. In multivariate analyses, BG in the highest tertile (≥8.6 mmol/L) was an independent predictor of functional handicap (odds ratio, 2.51; 95% CI, 1.43-4.40; P=0.01) and 1-month mortality (hazard ratio, 2.51; 95% CI, 1.23-2.43; P=0.002). The results were consistent with those obtained from multiple imputation analyses.

Conclusions: Admission hyperglycemia is associated with poor functional recovery at discharge and 1-month mortality after ICH. These results suggest a need for trials that evaluate strategies to lower BG in acute ICH.