1.Association between hemoglobin A1c and outcomes of patients with spontaneous intracerebral hemorrhage
Guanghui ZHANG ; Mingli HE ; Yan XU ; Xiaobing HE ; Pin MEN ; Na LIU ; Fangrong WU
Chinese Journal of Neuromedicine 2015;14(10):1018-1022
Objective Admission hyperglycemia is thought to be related to poor neurological function and high mortality in patients with spontaneous intracerebral hemorrhage (sICH).However, it is not known whether preictal glycemic status affects functional outcome of sICH.The study is aimed to disclose the association between preictal glycemic status and neurological outcomes in patients with acute sICH.Methods Three hundred and thirty-two patients with sICH, admitted to our hospital from January 2011 to September 2013 (within 24 h of onset), were chosen in our study.Pre-stroke glycemic status, represented by hemoglobin A1c (HbA1c), was determined the next day after admission.Patients were categorized into four groups according to HbA1c values (<6%, 6.1%-7%, 7.1%-8% and ≥8%).The correlations of HbA1c in the four groups with different variables (NIHSS scores, hematoma volume, modified Rankin scale [mRS] scores) were analyzed using Spearman correlation test.Patients were also categorized into two groups according to hematoma volume (≤25 mL or >25 mL) or mRS scores (≤2 or >2).Logistic regression analyses were used to determine the relative independent risk factors for both hematoma volume and mRS scores.Results The hematoma volume, NIHSS scores, mRS scores, and number of patients with diabetes mellitus were significantly different among the four groups (P<0.05).Blood glucose at admission and HbA1c level were significantly correlated with hematoma volume (r=0.085, P=0.027;r=0.164, P=0.014).Age and HbA1c level were significantly correlated with mRS scores (r=0.027, P=0.019;r=0.199, P=0.003).Conclusion HbA1C alone could serve as a better predictor of poor outcome after sICH than glucose at admission;HbA 1 C is the independent risk factor of poor prognosis for sICH.