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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Increased glucose levels and poor short-term prognosis after spontaneous intracerebral hemorrhage

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  • J.H. Tapia-Pérez - Department of Neurosurgery, Otto von Guericke University, Magdeburg, Germany
  • B. Voellger - Department of Neurosurgery, Otto von Guericke University, Magdeburg, Germany
  • R. Firsching - Department of Neurosurgery, Otto von Guericke University, Magdeburg, Germany
  • T. Schneider - Department of Neurosurgery, Otto von Guericke University, Magdeburg, Germany

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 038

doi: 10.3205/11dgnc259, urn:nbn:de:0183-11dgnc2592

Published: April 28, 2011

© 2011 Tapia-Pérez et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Spontaneous intracerebral hemorrhage (ICH) often represents a devastating event. Many factors are related to poor outcome after ICH. Increased plasma glucose levels seem to be related to poor outcome, but the precise association of glucose levels is not clear yet. We analyzed the association of glucose levels measured on admission, after 24 and 72 hours with short-term outcome.

Methods: From January 2008 to December 2009 we established a cohort of 122 patients with ICH. We excluded patients with head injury four weeks prior to admission, thrombolysis or tumor-associated hemorrhage, anticoagulation therapy, aneurysms or vascular malformations. Outcome criteria were mortality within 48 hours and within 7 days after onset of hemorrhage, in-patient mortality and NIHSS at discharge.

Results: 8 patients (6.6%) died within 48 hours, another 10 patients (8.2%) within 7 days and another 5 patients (4.1%) before discharge. Overall, 23 of 122 patients (18.9%) died in-hospital. In bivariate analysis, glucose serum levels on admission were significantly higher in patients who died within 7 days after onset of hemorrhage and in patients with an NIHSS>15 at discharge. Glucose serum levels at 24 hours after onset of hemorrhage were increased in patients with NIHSS>15 on admission and at discharge. Multivariate analysis did not show any impact of initial glucose serum levels on mortality within 48 hours. Glucose levels >180 mg/dl 72h after admission were associated with mortality within 7 days after onset of hemorrhage (OR= 8.35, 95%CI 1.5-45-5, p=0.01) and in-patient mortality (OR= 4.04, 95% CI 1.15-16.8, p=0.03). NIHSS >15 at discharge was not related to glucose levels. Increased white blood cell (WBC) counts appeared constantly as a factor related with poor outcome.

Conclusions: Increased glucose levels are related with initial stroke severity and poor outcome. Increased WBC on admission is also associated with poor outcome. Glucose serum levels and WBC possibly reflect stress and inflammatory response activated by ICH.