Persistent Hyperglycemia Is Associated With Increased Mortality After Intracerebral Hemorrhage

Show simple item record Wu, Teddy Y. Putaala, Jukka Sharma, Gagan Strbian, Daniel Tatlisumak, Turgut Davis, Stephen M. Meretoja, Atte 2017-09-12T10:16:00Z 2017-09-12T10:16:00Z 2017-08
dc.identifier.citation Wu , T Y , Putaala , J , Sharma , G , Strbian , D , Tatlisumak , T , Davis , S M & Meretoja , A 2017 , ' Persistent Hyperglycemia Is Associated With Increased Mortality After Intracerebral Hemorrhage ' , Journal of the American Heart Association , vol. 6 , no. 8 , 005760 .
dc.identifier.other PURE: 89561186
dc.identifier.other PURE UUID: 248fa312-728a-4cc8-89b1-27978e42fb3b
dc.identifier.other WOS: 000406948200013
dc.identifier.other Scopus: 85030672594
dc.identifier.other ORCID: /0000-0001-6433-1931/work/39205410
dc.description.abstract Background-Hyperglycemia may be associated with worse outcome after intracerebral hemorrhage (ICH). We assessed the association of early glycemic trajectory on ICH mortality and edema growth. Methods and Results-We included patients from the Helsinki ICH study with glucose measurements at least once between both 0 to 24 and 24 to 72 hours from onset. Hyperglycemia was defined as blood glucose >= 8 mmol/L (144 mg/dL) based on the local threshold for treatment. Glycemic trajectory was defined on maximum values 0 to 24 and 24 to 72 hours after ICH: (1) persistent normoglycemia in both epochs; (2) late hyperglycemia (only between 24 and 72 hours); (3) early hyperglycemia (only before 24 hours); and (4) persistent hyperglycemia in both epochs. Logistic regression with known predictors of outcome estimated the association of glycemic trajectory and 6-month mortality. A generalized linear model assessed the association of glycemic trajectory and interpolated 72-hour edema extension distance. A total of 576 patients met eligibility criteria, of whom 214 (37.2%) had persistent normoglycemia, 44 (7.6%) late hyperglycemia, 151 (26.2%) early hyperglycemia, and 167 (29.0%) persistent hyperglycemia. Six-month mortality was higher in the persistent (51.1%) and early (26.3%) hyperglycemia groups than the normoglycemia (19.0%) and late hyperglycemia (3.6%) groups. Persistent hyperglycemia was associated with 6-month mortality (odds ratio 3.675, 95% CI 1.989-6.792; P <0.001). Both univariate (P=0.426) and multivariable (P=0.493) generalized linear model analyses showed no association between glycemic trajectory and 72-hour edema extension distance. Conclusion-Early hyperglycemia after ICH is harmful if it is persistent. Strategies to achieve glycemic control after ICH may influence patient outcome and need to be assessed in clinical trials. en
dc.format.extent 26
dc.language.iso eng
dc.relation.ispartof Journal of the American Heart Association
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject edema
dc.subject glucose
dc.subject hyperglycemia
dc.subject intracerebral hemorrhage
dc.subject mortality
dc.subject HEMATOMA
dc.subject STROKE
dc.subject TRIAL
dc.subject MANAGEMENT
dc.subject SURVIVAL
dc.subject BEDSIDE
dc.subject 3112 Neurosciences
dc.subject 3124 Neurology and psychiatry
dc.title Persistent Hyperglycemia Is Associated With Increased Mortality After Intracerebral Hemorrhage en
dc.type Article
dc.contributor.organization Neurologian yksikkö
dc.contributor.organization Clinicum
dc.contributor.organization Department of Neurosciences
dc.contributor.organization HUS Neurocenter
dc.description.reviewstatus Peer reviewed
dc.relation.issn 2047-9980
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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