scholarly journals Association of early glycemic change with short-term mortality in lobar and non-lobar intracerebral hemorrhage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paola Forti ◽  
Fabiola Maioli ◽  
Marco Zoli
Keyword(s):  
Intracerebral Hemorrhage ◽  
Continuous Variable ◽  
Serum Glucose ◽  
Diabetic Patients ◽  
Short Term ◽  
Cox Models ◽  
Short Term Mortality ◽  
Glucose Test ◽  
Acute Intracerebral Hemorrhage ◽  
Persistent Hyperglycemia

AbstractThe association between early glycemic change and short-term mortality in non-diabetic patients with acute intracerebral hemorrhage (ICH) is unclear. We retrospectively investigated non-diabetic patients with lobar (n = 262) and non-lobar ICH (n = 370). Each patient had a random serum glucose test on hospital admission and a fasting serum glucose test within the following 48 h. Hyperglycemia was defined as serum glucose ≥ 7.8 mmol/l. Four patterns were determined: no hyperglycemia (reference category), persistent hyperglycemia, delayed hyperglycemia, and decreasing hyperglycemia. Associations with 30-day mortality were estimated using Cox models adjusted for major features of ICH severity. Persistent hyperglycemia was associated with 30-day mortality in both lobar (HR 3.00; 95% CI 1.28–7.02) and non-lobar ICH (HR 4.95; 95% CI 2.20–11.09). In lobar ICH, 30-day mortality was also associated with delayed (HR 4.10; 95% CI 1.77–9.49) and decreasing hyperglycemia (HR 2.01, 95% CI 1.09–3.70). These findings were confirmed in Cox models using glycemic change (fasting minus random serum glucose) as a continuous variable. Our study shows that, in non-diabetic patients with ICH, early persistent hyperglycemia is an independent predictor of short-term mortality regardless of hematoma location. Moreover, in non-diabetic patients with lobar ICH, both a positive and a negative glycemic change are associated with short-term mortality.

Abstract P411: Prevalence, Characteristics and Outcomes of Undetermined Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Konark MALHOTRA ◽  
Christina Zompola ◽  
Aikaterini Theodorou ◽  
Aristeidis Katsanos ◽  
Ashkan Shoamanesh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intracerebral Hemorrhage ◽  
Meta Analysis ◽  
Amyloid Angiopathy ◽  
Short Term ◽  
Pooled Prevalence ◽  
Subgroup Analyses ◽  
Short Term Mortality ◽  
Cerebral Amyloid ◽  
Undetermined Etiology

Objective: We sought to determine the prevalence, radiological characteristics, and clinical outcomes of intracerebral hemorrhage (ICH) of undetermined etiology. Methods: Systematic review and meta-analysis of studies involving patients with spontaneous ICH was conducted to assess the prevalence and clinical-radiological characteristics of undetermined ICH. Additionally, we assessed the rates for ICH secondary to hypertensive arteriopathy (HTN-A) and cerebral amyloid angiopathy (CAA). Subgroup analyses were performed based on the use of a) etiology-oriented ICH classification, b) detailed neuroimaging, and c) Boston criteria among CAA-ICH. Results: 24 studies were included (n=15,828; mean age: 64.8 years, males: 60.8%). The pooled prevalence of HTN-A ICH, undetermined ICH and CAA-ICH were 50% (95%CI: 43-58%), 18% (95%CI: 13-23%), and 12% (95%CI: 7-17%; p<0.001 between subgroups). The volume of ICH was largest in CAA-ICH 24.7mL (95%CI: 19.7-29.8mL), followed by HTN-A ICH 16.2mL (95%CI: 10.9-21.5mL) and undetermined ICH 15.4mL (95%CI: 6.2-24.5mL). Among patients with undetermined ICH, the rates of short-term mortality and intraventricular hemorrhage were 33% (95%CI: 25-42%) and 38% (95%CI: 28-48%), respectively. Subgroup analysis demonstrated a higher rate of undetermined ICH among studies that did not use an etiology-oriented classification (22%; 95%CI: 15-29%). No difference was observed between studies based on the completion of detailed neuroimaging to assess the rates of undetermined ICH (p=0.62). Conclusions: The etiology of spontaneous ICH remains undetermined among one in five patients in studies using etiology-oriented classification and among one in four patients in studies that avoid using etiology-oriented classification. The short-term mortality in undetermined ICH is high despite the relatively small ICH volume. Our findings suggest the use of etiology-oriented classification to approach ICH patients (Figure).

Predictors of Supratentorial Deep Intracerebral Hemorrhage Volume and Their Effect on Short-Term Mortality in Asians

2016 ◽  
Vol 42 (5-6) ◽  
pp. 319-331 ◽  
Author(s):  
Myung Hoon Han ◽  
Jae Min Kim ◽  
Hyeong-Joong Yi ◽  
Jin Hwan Cheong ◽  
Yong Ko ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Intracerebral Hemorrhage ◽  
Regression Line ◽  
Normal Weight ◽  
Short Term ◽  
Risk Of Death ◽  
Increased Risk ◽  
Short Term Mortality ◽  
Relevant Variables ◽  
Underlying Mechanisms

Background: The volume of intracerebral hemorrhage (ICH) measured at hospital admission is the strongest predictor of clinical outcomes in patients with ICH. Despite the high incidence rate of ICH in Asians, there is lack of data regarding predictors of ICH volume in this ethnic group. The purpose of this study was to determine predictors of deep ICH volume and examine their effect on short-term mortality in Asians. Methods: Hematoma volume was measured using the ABC/2 method. ICH volume was transformed to the natural log scale to normalize distributions for all analyses. We estimated the coefficients of ICH volume based on relevant predictors using multivariable linear regression. We also determined the association between body mass index (BMI) and ICH volume using a regression line and a line determined by a locally weighted scatter plot smoothing. Results: A total of 1,039 patients from 2 twin hospitals in Korea who were admitted with primary spontaneous supratentorial deep ICH over a 12-year period were enrolled in this study. The median ICH volume was 19.7 ml. The average patient age was 59.2, and 62.4% of patients were men. The mean ICH volume showed a gradual, approximately 2% decrease per 1 BMI increase in the current study, after adjusting for all relevant variables (β = -0.024; SE 0.004; p < 0.001). In addition, patients with frequent alcohol consumption showed a 10% increase in mean ICH volume (β = 0.098; SE 0.041; p = 0.016), and patients undergoing warfarin treatment showed a 30% increase in mean ICH volume after full adjustment of all relevant variables (β = 0.296; SE 0.050; p < 0.001). Relative to overweight patients, there was a 47, 11, and 18% increase in admission mean ICH volume in underweight, normal weight and obese patients, respectively. Patients in the first quartile and underweight BMI groups had 1.45-fold (hazard ratio (HR) 1.45; 95% CI 1.03-2.03; p = 0.035) and 1.77-fold (HR 1.77; 95% CI 1.10-2.84; p = 0.019) higher increased risk of death during the first 3 months after ICH, retrospectively. In addition, patients in groups with frequent alcohol consumption and warfarin use both showed a significant association with mortality 90 days after ICH. Conclusions: We demonstrated the association between various predictors and admission ICH volume with short-term mortality in Asians. Further studies are needed to account for these observations and determine their underlying mechanisms.

Abstract TP336: Characteristics and Outcome of Patients With Acute Intracerebral Hemorrhage Who Overuse Alcohol

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Carla Avellaneda-Gómez ◽  
Maria Serra Martínez ◽  
Alejandra Gómez González ◽  
Ana Rodríguez-Campello ◽  
Angel Ois ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Alcohol Intake ◽  
Short Term ◽  
Acute Intracerebral Hemorrhage ◽  
Stroke Center ◽  
Ich Score ◽  
Heavy Alcohol Intake ◽  
Long Term Mortality

Background: Alcohol overuse (AO) is considered a cause of spontaneous intracerebral hemorrhage (ICH), but the clinical and outcome characteristics of these patients (AO+ICH) are not well known. Methods: All patients with ICH admitted from January 2005 to June 2015 to a single university tertiary stroke center were prospectively studied and followed up during 5 years. Demographic features, radiological characteristics, and clinical outcome of patients with acute ICH and previous heavy alcohol intake (>40 gr/day or >300 gr/week) were analyzed. Results: During the study period, 609 patients with ICH were admitted. Nineteen patients were excluded because data on alcohol intake was not available. At admission, 83 patients (13.6%) were identified with AO (22.7% of men vs 2.9% of women; p< 0.0001) and was more frequent in younger patients (mean age, 63.11 years, compared to 72.7 years overall; p< 0.0001). Smoking was associated with AO (63,9% vs 13,8% non-AO; p< 0.0001) but not significant differences were found according with cardiovascular risk factors (dyslipidemia, diabetes and hypertension). ICH score was lower in the AO group (1.3 vs 1.8, p= 0.009) and deep ICH were more frequent (p= 0.036), compared to non-AO. Adjusted by sex, age, and high blood pressure, a trend in favor of increased deep ICH in AO patients remained (HR: 1.68 [95% CI: 0.92-3.05], p= 0.086). Adjusted mortality at 3-month, 12-month, and 5-year follow-up was similar in both groups. Conclusions: AO was present in 13.6% of ICH patients. These patients were an average of 11.5 years younger, predominantly men, and smokers, compared to the non-AO group. Adjusted short-term and long-term mortality was similar in AO and non-AO groups.

Sulfonylurea drug pretreatment and functional outcome in diabetic patients with acute intracerebral hemorrhage

2017 ◽  
Vol 381 ◽  
pp. 182-187 ◽  
Author(s):  
Jason J. Chang ◽  
Yasser Khorchid ◽  
Ali Kerro ◽  
L. Goodwin Burgess ◽  
Nitin Goyal ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Diabetic Patients ◽  
Acute Intracerebral Hemorrhage

scholarly journals Influence of Weekend Hospital Admission on Short-Term Mortality After Intracerebral Hemorrhage

Stroke ◽  
2009 ◽  
Vol 40 (7) ◽  
pp. 2387-2392 ◽  
Author(s):  
R. Webster Crowley ◽  
Hian K. Yeoh ◽  
George J. Stukenborg ◽  
Ricky Medel ◽  
Neal F. Kassell ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Hospital Admission ◽  
Short Term ◽  
Short Term Mortality

scholarly journals Serum glucose and potassium ratio as a predictive factor for prognosis of acute intracerebral hemorrhage

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110096
Author(s):  
Xiao-Yu Wu ◽  
Yao-Kun Zhuang ◽  
Yong Cai ◽  
Xiao-Qiao Dong ◽  
Ke-Yi Wang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Characteristic Curve ◽  
Serum Glucose ◽  
Clinical Variable ◽  
Hematoma Volume ◽  
Nihss Score ◽  
Patients At Risk ◽  
Acute Intracerebral Hemorrhage ◽  
Poor Outcomes ◽  
Gcs Score

Objective The serum glucose/potassium ratio (GPR) is a potential prognostic predictor for acute brain injury-related diseases. We calculated the serum GPR in patients with acute intracerebral hemorrhage (ICH) and explored its prognostic value for long-term prognoses and ICH severity. Methods This retrospective cohort study consecutively included 92 patients with ICH and 92 healthy controls. The National Institutes of Health Stroke Scale (NIHSS) score, Glasgow coma scale (GCS) score, and hematoma volume were used to assess severity. A modified Rankin Scale score > 2 at 90 days post-stroke was defined as a poor outcome. Results The serum GPR was significantly higher in patients than controls. The serum GPR was weakly correlated with the NIHSS score, GCS score, and hematoma volume. The serum GPR, GCS score, and hematoma volume were independently associated with poor outcomes. In the receiver operating characteristic curve analysis, the serum GPR remarkably discriminated patients at risk of poor outcomes at 90 days. The serum GPR significantly improved the prognostic predictive capability of hematoma volume and tended to increase that of the GCS score. Conclusion Serum GPR is an easily obtained clinical variable for predicting clinical outcomes after ICH.

scholarly journals HBA1c Levels In Non-Diabetic Patients with ST Elevated Myocardial Infarction & its Correlation with Short Term Mortality

2020 ◽  
Vol 4 (4) ◽  
pp. 01-05
Author(s):  
Arnab Chaudhury
Keyword(s):  
Myocardial Infarction ◽  
Patient Characteristics ◽  
Multivariate Regression Analysis ◽  
Study Data ◽  
Mortality Data ◽  
Diabetic Patients ◽  
Short Term ◽  
All Cause Mortality ◽  
Short Term Mortality ◽  
Study Population

Background: Elevated HBA1C level is predictive for cardiovascular disease and mortality in diabetic & also in non-diabetic patients. Aim of our study was to evaluate correlation between HBA1c on admission and short term mortality in non-diabetic patients with ST elevated myocardial infarction. Methods: 266 non-diabetic patients presenting with STEMI (within 48 hours) were included in our study. Data regarding patient characteristics were collected over 7 months. All-cause mortality data collected prospectively up to 6 months. Results: Mean HBA1C was 5.69±0.65 for the study population. HBA1C quartiles (<5, 5.1-5.5, 5.6-6, 6.1-6.4) has shown increased 6 months mortality (3%, 4.8%, 1.7%, 15.1% respectively P=0.004) with increased values. Multivariate regression analysis has shown HBA1C>6 as an independent predictor of 6 month mortality. Conclusion: A significant correlation exists between HBA1C on admission in non-diabetic patients with STEMI and 6 month all-cause mortality.

scholarly journals Relationship Between Glycosylated Hemoglobin and Short-Term Mortality of Spontaneous Intracerebral Hemorrhage

2021 ◽  
Vol 12 ◽  
Author(s):  
Ping Lu ◽  
Lingyun Cui ◽  
Yu Wang ◽  
Kaijiang Kang ◽  
Hongqiu Gu ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Large Scale ◽  
Glycosylated Hemoglobin ◽  
Cross Sectional Study ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Short Term ◽  
Cross Sectional ◽  
Short Term Mortality ◽  
The Relationship ◽  
Hba1c Levels

Background: The relationship between glycosylated hemoglobin (HbA1c) and prognosis of spontaneous intracerebral hemorrhage (SICH) patients has not been fully elucidated. This study aimed to reveal the relationship between HbA1c levels and short-term mortality after patient admission with SICH.Methods: It was a large-scale, multicenter, cross-sectional study. From August 1, 2015, to July 31, 2019, a total of 41910 SICH patients were included in the study from the Chinese Stroke Center Alliance (CSCA) program. Finally, we comprehensively analyzed the data from 21,116 patients with SICH. HbA1c was categorized into four groups by quartile. Univariate and multivariate logistic regression analyses were used to assess the association between HbA1c levels and short-term mortality in SICH patients.Results: The average age of the 21,116 patients was 62.8 ± 13.2 years; 13,052 (61.8%) of them were male, and 507 (2.4%) of them died. Compared to the higher three quartiles of HbA1c, the lowest quartile (≤5.10%) had higher short-term mortality. In subgroup analysis with or without diabetes mellitus (DM) patients, the mortality of the Q3 group at 5.60–6.10% was significantly lower than that of the Q1 group at ≤5.10%. After adjustment for potential influencing factors, the ROC curve of HbA1c can better predict the short-term mortality of patients with SICH (AUC = 0.6286 P &lt; 0.001).Conclusions: Therefore, we concluded that low or extremely low HbA1c levels (≤5.10%) after stroke were associated with higher short-term mortality in SICH patients, with or without DM.

Effect of Moderate and Severe Persistent Hyperglycemia on Outcomes in Patients With Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Wei Huang ◽  
Iryna Lobanova ◽  
Premkumar N. Chandrasekaran ◽  
Daniel F. Hanley ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Scale Score ◽  
Odds Ratio ◽  
Serum Glucose ◽  
Hematoma Volume ◽  
Unique Identifier ◽  
Glucose Levels ◽  
Risk Of Death ◽  
The Relationship ◽  
Persistent Hyperglycemia

Background and Purpose: We evaluated the effect of persistent hyperglycemia on outcomes in 1000 patients with intracerebral hemorrhage enrolled within 4.5 hours of symptom onset. Methods: We defined moderate and severe hyperglycemia based on serum glucose levels ≥140 mg/dL—<180 and ≥180 mg/dL, respectively, measured at baseline, 24, 48, and 72 hours. Persistent hyperglycemia was defined by 2 consecutive (24 hours apart) serum glucose levels. We evaluated the relationship between moderate and severe hyperglycemia and death or disability (defined by modified Rankin Scale score of 4–6) at 90 days in the overall cohort and in groups defined by preexisting diabetes. Results: In the multivariate analysis, both moderate (odds ratio, 1.8 [95% CI, 1.1–2.8]) and severe (odds ratio, 1.8 [95% CI, 1.2–2.7]) hyperglycemia were associated with higher 90-day death or disability after adjusting for Glasgow Coma Scale score, hematoma volume, presence or absence of intraventricular hemorrhage, hyperlipidemia, cigarette smoking, and hypertension (no interaction between hyperglycemia and preexisting diabetes, P =0.996). Among the patients without preexisting diabetes, both moderate (odds ratio, 1.8 [95% CI, 1.0–3.2]) and severe (odds ratio, 2.0 [95% CI, 1.1–3.7]) hyperglycemia were associated with 90-day death or disability after adjusting for above mentioned potential confounders. Among the patients with preexisting diabetes, moderate and severe hyperglycemia were not associated with 90-day death or disability. Conclusions: Persistent hyperglycemia, either moderate or severe, increased the risk of death or disability in nondiabetic patients with intracerebral hemorrhage. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01176565.

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