Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Curr Neurovasc Res. 2019;16(1):40-46. doi: 10.2174/1567202616666190131164108.
Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH.
Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes.
One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders.
Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.
高血糖与自发性脑出血(ICH)患者的不良预后相关,但原发性脑室出血(PIVH)患者血糖水平与预后之间的关系尚不清楚。我们旨在确定与入院时高血糖相关的参数,并分析 PIVH 患者高血糖对临床结局的影响。
本研究回顾性纳入 2010 年至 2016 年期间在华西医院神经外科就诊的 PIVH 患者。收集临床、影像学和实验室数据。采用单因素和多因素 logistic 回归分析确定不良结局的独立预测因素。
共纳入 170 例患者。入院时平均血糖水平为 7.78±2.73mmol/L,10 例(5.9%)患者有糖尿病病史。糖尿病病史(P=0.01;优势比[OR],9.10;95%置信区间[CI],1.64 至 50.54)是定义为 8.17mmol/L 的入院时危急高血糖的独立预测因素。入院时危急高血糖患者出院时(P<0.001)和 90 天时(P<0.001)的结局更差。校正后,入院血糖与出院(P=0.01;OR,1.30;95%CI,1.06 至 1.59)和 90 天不良结局(P=0.03;OR,1.27;95%CI,1.03 至 1.58)以及 90 天死亡率(P=0.005;OR,1.41;95%CI,1.11 至 1.78)显著相关。此外,即使在校正了混杂因素后,入院时危急高血糖仍显著增加了 PIVH 患者肺炎的发生率(P=0.02;OR,6.04;95%CI,1.27 至 28.80)。
PIVH 后入院血糖与出院及 90 天不良预后以及 90 天死亡率相关。入院高血糖显著增加了 PIVH 患者肺炎的发生率。