Blood glucose levels during the initial 72 h and 3-month functional outcomes in acute intracerebral hemorrhage: the SAMURAI-ICH study

Masatoshi Koga, Hiroshi Yamagami, Satoshi Okuda, Yasushi Okada, Kazumi Kimura, Yoshiaki Shiokawa, Jyoji Nakagawara, Eisuke Furui, Yasuhiro Hasegawa, Kazuomi Kario, Shoji Arihiro, Shoichiro Sato, Kazunari Homma, Takayuki Matsuki, Naoto Kinoshita, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda
Journal of the Neurological Sciences 2015 March 15, 350 (1-2): 75-8

PURPOSE: Prognostic values of blood glucose levels following admission remain unclear. We investigated associations between blood glucose levels during the initial 72 h and outcomes of acute ICH.

METHODS: Participants comprised hyperacute ICH patients who received intravenous antihypertensive treatment. Blood glucose levels were measured on admission and at 24 and 72 h after starting treatment, along with hemoglobin (Hb)A1c level on admission. Associations with clinical outcomes of hematoma expansion (>33% increase), none to minimal disability (3-month modified Rankin Scale [mRS] 0-1) and bedridden or death (3-month mRS 5-6) were analyzed.

RESULTS: Of the 176 patients (70 women; 65 ± 12 years), 30 (18%) showed hematoma expansion, and 33 (19%) had none to minimal disability and 15 (10%) were bedridden or died. On multivariate regression analysis, blood glucose at 24h (per 10mg/dl odds ratio [OR], 0.84; 95% confidence interval [CI], 0.69-0.98) and blood glucose at 72 h (OR, 0.75; 95%CI, 0.59-0.92) were inversely associated with none to minimal disability, and blood glucose at 24h (OR, 1.14; 95%CI, 1.00-1.30) was positively associated with bedridden or death. No parameters were associated with hematoma expansion.

CONCLUSIONS: High blood glucose levels at 24 and 72 h were independently associated with poor functional outcomes 3 months after ICH. We need to investigate whether blood glucose control during the acute period ameliorates clinical outcomes.


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