The Deleterious Effect of Admission Hyperglycemia on Survival and Functional Outcome in Patients With Intracerebral Hemorrhage
The Deleterious Effect of Admission Hyperglycemia on Survival and Functional Outcome in Patients With Intracerebral Hemorrhage
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DOI：
10.1161/strokeaha.111.632950
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发表时间：
2012-01-01
期刊：
影响因子：
8.3
通讯作者：
Giroud, Maurice
中科院分区：
文献类型：
--
作者：
Bejot, Yannick;Aboa-Eboule, Corine;Giroud, Maurice
背景与目的——我们旨在评估入院时血糖（BG）水平与脑出血（ICH）患者出院时的功能预后以及1个月死亡率之间的关联。方法——从1985年到2009年法国第戎基于人群的卒中登记处确定所有首次发生的脑出血病例。记录临床和影像学信息。入院时测量血糖。使用逻辑回归和考克斯回归模型进行多变量分析。将多重填补作为敏感性分析。结果——我们记录了465例首次发生的脑出血。416例患者（89.5%）获得了入院时的血糖值，中位值为6.92 mmol/L。在多变量分析中，血糖处于最高三分位数（≥8.6 mmol/L）是功能残疾（优势比，2.51；95%置信区间，1.43 - 4.40；P = 0.01）和1个月死亡率（风险比，2.51；95%置信区间，1.23 - 2.43；P = 0.002）的独立预测因素。结果与多重填补分析所得结果一致。结论——入院时高血糖与脑出血患者出院时功能恢复不良以及1个月死亡率相关。这些结果提示需要开展试验来评估降低急性脑出血患者血糖的策略。（《卒中》。2012；43：243 - 245）
Background and Purpose-We aimed to evaluate the association between blood glucose (BG) levels at admission and both functional outcome at discharge and 1-month mortality after intracerebral hemorrhage (ICH).Methods-All cases of first-ever ICH were identified from the population-based Stroke Registry of Dijon, France from 1985 to 2009. Clinical and radiological information was recorded. BG was measured at admission. Multivariate analyses were performed using logistic and Cox regression models. Multiple imputation was used as a sensitivity analysis.Results-We recorded 465 first-ever ICH. BG at admission was obtained in 416 patients (89.5%) with a median value of 6.92 mmol/L. In multivariate analyses, BG in the highest tertile (>= 8.6 mmol/L) was an independent predictor of functional handicap (odds ratio, 2.51; 95% CI, 1.43-4.40; P=0.01) and 1-month mortality (hazard ratio, 2.51; 95% CI, 1.23-2.43; P=0.002). The results were consistent with those obtained from multiple imputation analyses.Conclusions-Admission hyperglycemia is associated with poor functional recovery at discharge and 1-month mortality after ICH. These results suggest a need for trials that evaluate strategies to lower BG in acute ICH. (Stroke. 2012;43: 243-245.)