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Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage

BACKGROUND: Stress hyperglycemia is a common condition in patients suffering from critical illness such as spontaneous intracerebral hemorrhage (ICH). Our study aimed to use glucose-to-glycated hemoglobin (HbA1c) ratio to investigate the impact of stress hyperglycemia on clinical outcomes in patient...

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Autores principales: Li, Sijia, Wang, Yu, Wang, Wenjuan, Zhang, Qian, Wang, Anxin, Zhao, Xingquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9235136/
https://www.ncbi.nlm.nih.gov/pubmed/35761206
http://dx.doi.org/10.1186/s12883-022-02760-9
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author Li, Sijia
Wang, Yu
Wang, Wenjuan
Zhang, Qian
Wang, Anxin
Zhao, Xingquan
author_facet Li, Sijia
Wang, Yu
Wang, Wenjuan
Zhang, Qian
Wang, Anxin
Zhao, Xingquan
author_sort Li, Sijia
collection PubMed
description BACKGROUND: Stress hyperglycemia is a common condition in patients suffering from critical illness such as spontaneous intracerebral hemorrhage (ICH). Our study aimed to use glucose-to-glycated hemoglobin (HbA1c) ratio to investigate the impact of stress hyperglycemia on clinical outcomes in patients with ICH. METHODS: A sample of eligible 586 patients with spontaneous intracerebral hemorrhage from a multicenter, hospital-based cohort between 2014 and 2016 were recruited in our study. Stress hyperglycemia was evaluated by the index of the glucose-to-HbA1c ratio that was calculated by fasting blood glucose (mmol/L) divided by HbA1c (%). Patients were divided into two groups based on the median of the glucose-to-HbA1c ratio. The main outcomes were poor functional outcomes (modified Rankin Scale score of 3–6) at discharge and 90 days. Multivariable logistic regression and stratified analyses were performed to explore the association of stress hyperglycemia with poor prognosis of ICH. RESULTS: On multivariable analysis, higher glucose-to-HbA1c ratio (≥1.02) was independently correlated with poor functional outcomes at discharge (adjusted OR = 3.52, 95%CI: 1.98–6.23) and 90 days (adjusted OR = 2.27, 95%CI: 1.38–3.73) after adjusting for potential confounding factors. The correlation between glucose-to-HbA1c ratio and worse functional outcomes still retained in patients with or without diabetes mellitus. CONCLUSIONS: Stress hyperglycemia, calculated by glucose-to-HbA1c ratio, was independently correlated with worse functional outcomes at discharge and 90 days in patients with ICH. Moreover, glucose-to-HbA1c ratio, might not only be used as a simple and readily available index to predict clinical outcomes of ICH but also provide meaningful insight into future analysis to investigate the optimal range of glucose levels among ICH patients and develop tailored glucose-lowering strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02760-9.
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spelling pubmed-92351362022-06-28 Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage Li, Sijia Wang, Yu Wang, Wenjuan Zhang, Qian Wang, Anxin Zhao, Xingquan BMC Neurol Research BACKGROUND: Stress hyperglycemia is a common condition in patients suffering from critical illness such as spontaneous intracerebral hemorrhage (ICH). Our study aimed to use glucose-to-glycated hemoglobin (HbA1c) ratio to investigate the impact of stress hyperglycemia on clinical outcomes in patients with ICH. METHODS: A sample of eligible 586 patients with spontaneous intracerebral hemorrhage from a multicenter, hospital-based cohort between 2014 and 2016 were recruited in our study. Stress hyperglycemia was evaluated by the index of the glucose-to-HbA1c ratio that was calculated by fasting blood glucose (mmol/L) divided by HbA1c (%). Patients were divided into two groups based on the median of the glucose-to-HbA1c ratio. The main outcomes were poor functional outcomes (modified Rankin Scale score of 3–6) at discharge and 90 days. Multivariable logistic regression and stratified analyses were performed to explore the association of stress hyperglycemia with poor prognosis of ICH. RESULTS: On multivariable analysis, higher glucose-to-HbA1c ratio (≥1.02) was independently correlated with poor functional outcomes at discharge (adjusted OR = 3.52, 95%CI: 1.98–6.23) and 90 days (adjusted OR = 2.27, 95%CI: 1.38–3.73) after adjusting for potential confounding factors. The correlation between glucose-to-HbA1c ratio and worse functional outcomes still retained in patients with or without diabetes mellitus. CONCLUSIONS: Stress hyperglycemia, calculated by glucose-to-HbA1c ratio, was independently correlated with worse functional outcomes at discharge and 90 days in patients with ICH. Moreover, glucose-to-HbA1c ratio, might not only be used as a simple and readily available index to predict clinical outcomes of ICH but also provide meaningful insight into future analysis to investigate the optimal range of glucose levels among ICH patients and develop tailored glucose-lowering strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-022-02760-9. BioMed Central 2022-06-27 /pmc/articles/PMC9235136/ /pubmed/35761206 http://dx.doi.org/10.1186/s12883-022-02760-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Li, Sijia
Wang, Yu
Wang, Wenjuan
Zhang, Qian
Wang, Anxin
Zhao, Xingquan
Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
title Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
title_full Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
title_fullStr Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
title_full_unstemmed Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
title_short Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
title_sort stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9235136/
https://www.ncbi.nlm.nih.gov/pubmed/35761206
http://dx.doi.org/10.1186/s12883-022-02760-9
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