Hyperglycemia within day 14 of aneurysmal subarachnoid hemorrhage predicts 1-year mortality

Objectives: To assess whether the fasting glucose level on admission, day 14 or their variation in patients with aSAH was associated with 1-year mortality. Methods: A prospective study was undertaken to analyze the effects of fasting glucose on admission, day 14 and their variation on the 1-year mortality rate after aSAH. Patients with aSAH were enrolled to assess the mortality rate relationship with fasting glucose, medical history, clinical and radiological grades. Multivariate Cox regression analysis was performed to assess risk factors for 1-year mortality. Results: A total of 239 aSAH patients without history of diabetes were followed up, with the 1-year mortality being 11.7%. Admission glucose levels were found to be associated with 1-year mortality after being adjusted for other confounding factors in Cox regression (HR: 1.524 per mmol/L; 95%CI, 1.250-1.859). Within 14 days, fasting glucose levels of 85 patients had increased. Patients who died also exhibited higher levels of glucose (dead vs. survival: 61.54% vs. 33.66%, p < 0.01). In addition, higher blood glucose levels were associated with an elevated I-year mortality (HR: 1.350 per mmol/L; 95%CI, 1.153-1.580). Conclusions: Glucose levels at admission as well as their variation after aSAH are predictive of an elevated 1-year mortality rate. (C) 2012 Elsevier B.V. All rights reserved.