Effects of admission glucose level on mortality after subarachnoid hemorrhage: A comparison between short-term and long-term mortality

Background: Admission hyperglycemia is associated with poor functional outcomes and risk of death in nondiabetic patients with acute ischemic stroke. However, there is still some debate about the effects of hyperglycemia in subarachnoid hemorrhage (SAH) patients. The purpose of this study was to assess whether the admission glucose level in patients with SAH is associated with short- and/or long-term mortality. Methods: A consecutive data set of SAH patients without diabetes was obtained from a prospective multicenter cohort of hemorrhagic stroke patients. The effects of glucose level were examined in relation to short- (30 days) or long-term mortality using COX regression analysis. To eliminate the short-term effects of glucose level, the long-term effects were analyzed in the patients who survived for more than 30 days. Results: A total of 803 SAH patients were followed up in this study. The 30-day and final mortalities were 7.6% and 12.0%, respectively. Throughout the entire follow-up period, glucose level was found to be significantly associated with final mortality after adjusting for potential confounders (adjusted HR, 1.10; 95% Cl, 1.01 to 1.19). Moreover, glucose level was found to be associated with short-term mortality (adjusted HR, 1.15; 95% Cl, 1.05 to 1.27), but not with long-term mortality (adjusted HR, 0.97; 95% Cl, 0.82 to 1.14). Conclusions: We demonstrated that admission hyperglycemia has a harmful effect on short-term mortality, but not with long-term mortality in SAH patients without diabetes. Our results may be used as further evidence to support a hypothesis of harmful effects of hyperglycemia in SAH patients. (C) 2008 Elsevier BY. All rights reserved.