Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
Department of Radiology, the Third People's Hospital of Qingdao, Qingdao, 266041, China.
BMC Neurol. 2024 Jul 15;24(1):244. doi: 10.1186/s12883-024-03758-1.
Elevated blood glucose (BG) variability has been reported as an independent risk factor for poor prognosis in a variety of diseases. This study aimed to investigate the association between BG variability and clinical outcomes in patients with spontaneous cerebellar hemorrhage (SCH) undergoing surgical operation.
This retrospective cohort study of the consecutive patients admitted to the department of Neurosurgery, the Affiliated Hospital of Qingdao University between January 2014 and June 2022 with the diagnosis of SCH underwent surgical intervention. BG analysis was continuously and routinely performed. BG variability was represented by the standard deviation (SD) of the serial measurements within the first 7 days. The general characteristics, imageological information, blood glucose level, and surgical information were reviewed and compared through medical records.
A total of 115 patients (65 male and 50 female) were enrolled. Out of all 115 patients, the overall clinical outcomes according to the modified Rankin Scale (mRS) were poor (mRS 3-6) in 31 patients (26.96%) and good (mRS 0-2) in 84 patients (73.04%). Twelve of the 115 patients died during hospitalization, and the mortality rate was 10.43%. Multivariate logistic regression analysis showed that SD of BG (odds ratio (OR), 4.717; 95% confidence interval (CI), 1.054-21.115; P = 0.043), GCS (OR, 0.563; 95% CI, 0.330-0.958; P = 0.034), and hematoma volume (OR, 1.395; 95% CI, 1.118-1.748; P = 0.003) were significant predictors. The area under the ROC curve of SD of BG was 0.911 (95% CI, 0.850-0.973; P < 0.001) with a sensitivity and specificity of 90.3% and 83.3%, respectively, and the cut-off value was 1.736.
High BG Variability is independently correlated with the 6-month poor outcomes in patients with SCH undergoing surgical operation.
高血糖变异性已被报道为多种疾病不良预后的独立危险因素。本研究旨在探讨手术治疗自发性小脑出血（SCH）患者血糖变异性与临床结局的关系。
本回顾性队列研究纳入了 2014 年 1 月至 2022 年 6 月期间在青岛大学附属医院神经外科连续收治的接受手术治疗的 SCH 患者。连续 7 天内的血糖测量值的标准差（SD）来表示血糖变异性。通过病历回顾和比较患者的一般特征、影像学信息、血糖水平和手术信息。
共纳入 115 例患者（65 例男性和 50 例女性）。根据改良 Rankin 量表（mRS）评估，115 例患者中，整体临床结局不良（mRS 3-6）者 31 例（26.96%），良好（mRS 0-2）者 84 例（73.04%）。115 例患者中有 12 例在住院期间死亡，死亡率为 10.43%。多因素 logistic 回归分析显示，BG 的 SD（比值比（OR），4.717；95%置信区间（CI），1.054-21.115；P=0.043）、GCS（OR，0.563；95%CI，0.330-0.958；P=0.034）和血肿量（OR，1.395；95%CI，1.118-1.748；P=0.003）是显著的预测因子。BG 的 SD 的 ROC 曲线下面积为 0.911（95%CI，0.850-0.973；P<0.001），灵敏度和特异度分别为 90.3%和 83.3%，截断值为 1.736。
高血糖变异性与手术治疗 SCH 患者 6 个月预后不良独立相关。
