Background: The role of admission blood glucose level on the prognosis of pati ents with intracerebral haemorrhage has not been elucidated. Objective: To exami ne this association on the basis of an epidemiologically ...Background: The role of admission blood glucose level on the prognosis of pati ents with intracerebral haemorrhage has not been elucidated. Objective: To exami ne this association on the basis of an epidemiologically representative patient material.Methods: 249 500 people living in the catchment area of the Central Hos pital of Central Finland. The diagnosis of ICH was established if verified by cr anial computed tomography(CT) or autopsy. Results: Of the 416 patients who fulfi lled the diagnostic criteria, 30 died before admission and 386 were admitted to the Central Hospital. All 329 patients (290 nondiabetics and 39 diabetics) with both admission blood glucose and cranial CT data were included in the study. The mean blood glucose level was 10.6 mmol/l for nondiabetics who died on the day o f onset, 8.6 mmol/l for those dying during days 1 to 28, and 6.8 mmol/l for the 28 day survivors. The corresponding figures for diabetics were 13.9 mmol/l, 12.5 mmol/l,and 9.3 mmol/l. In both nondiabetics and diabetics, patients who died ha d significantly higher mean glucose than the 28 day survivors (p < 0.0001 versus p=0.029). However, blood glucose of the surviving diabetics was as high as that of the deceased nondiabetics (9.3 mmol/l versus 9.1 mmol/l). In nondiabetics,ad mission blood glucose was associated with parameters signifying severe stroke; d isturbed consciousness, large haematoma volume and shift of cerebral midline str uctures, and high admission mean arterial pressure. In logistic regression analy sis, high admission blood glucose in nondiabetics was a significant predictor of death during the first 28 days of onset(odds ratio 1.22, 95%CI 1.07 to 1.40). Conclusions: High admission blood glucose predicts increased 28 day case fatalit y rate in both nondiabetic and diabetic patients with ICH. Because high admissio n blood glucose was associated with markers of severe stroke, we are inclined to support the stress theory; high admission blood glucose is the result of a seri ous ICH.展开更多
文摘Background: The role of admission blood glucose level on the prognosis of pati ents with intracerebral haemorrhage has not been elucidated. Objective: To exami ne this association on the basis of an epidemiologically representative patient material.Methods: 249 500 people living in the catchment area of the Central Hos pital of Central Finland. The diagnosis of ICH was established if verified by cr anial computed tomography(CT) or autopsy. Results: Of the 416 patients who fulfi lled the diagnostic criteria, 30 died before admission and 386 were admitted to the Central Hospital. All 329 patients (290 nondiabetics and 39 diabetics) with both admission blood glucose and cranial CT data were included in the study. The mean blood glucose level was 10.6 mmol/l for nondiabetics who died on the day o f onset, 8.6 mmol/l for those dying during days 1 to 28, and 6.8 mmol/l for the 28 day survivors. The corresponding figures for diabetics were 13.9 mmol/l, 12.5 mmol/l,and 9.3 mmol/l. In both nondiabetics and diabetics, patients who died ha d significantly higher mean glucose than the 28 day survivors (p < 0.0001 versus p=0.029). However, blood glucose of the surviving diabetics was as high as that of the deceased nondiabetics (9.3 mmol/l versus 9.1 mmol/l). In nondiabetics,ad mission blood glucose was associated with parameters signifying severe stroke; d isturbed consciousness, large haematoma volume and shift of cerebral midline str uctures, and high admission mean arterial pressure. In logistic regression analy sis, high admission blood glucose in nondiabetics was a significant predictor of death during the first 28 days of onset(odds ratio 1.22, 95%CI 1.07 to 1.40). Conclusions: High admission blood glucose predicts increased 28 day case fatalit y rate in both nondiabetic and diabetic patients with ICH. Because high admissio n blood glucose was associated with markers of severe stroke, we are inclined to support the stress theory; high admission blood glucose is the result of a seri ous ICH.
