TY - JOUR
T1 - Acute hyperglycemia is associated with intraventricular extension among patients with spontaneous intracerebral hemorrhage
AU - Das, Alvin S.
AU - Erdman, John W.
AU - Heistand, Elizabeth C.
AU - Lioutas, Vasileios Arsenios
AU - Fehnel, Corey R.
AU - Yoon, Jason
AU - Kumar, Sandeep
AU - Regenhardt, Robert W.
AU - Gurol, M. Edip
AU - Ngo, Long H.
AU - Benitez, Bruno A.
AU - Selim, Magdy H.
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/12/15
Y1 - 2024/12/15
N2 - Objective: Acute hyperglycemia following intracerebral hemorrhage (ICH) is associated with poor functional outcomes and may result from a neuroendocrine stress response. Given the proximity of neuroendocrine structures to the cerebral ventricles, we tested the hypothesis that intraventricular hemorrhage (IVH) is associated with hyperglycemia. Materials and methods: A post-hoc analysis of the ICH Deferoxamine (i-DEF) trial was conducted to determine predictors of IVH. Variables with significant differences (p < 0.1) in univariable tests between patients with and without IVH were entered into a logistic regression model along with age, sex, diabetes, hyperglycemia (admission glucose ≥140 mg/dL), and baseline intraparenchymal hemorrhage (IPH) volume. This model was then applied to an independent cohort of consecutive non-traumatic ICH patients admitted to a single referral center (2007 to 2018). Results: Among 294 patients in the i-DEF cohort with mean age 60 ± 12 years (IVH in 41 %), hyperglycemia (aOR 1.90, 95 % CI [1.06–3.38]), smoking history (aOR 1.90, 95 % CI [1.11–3.27]), and non-lobar ICH location (aOR 3.38, 95 % CI [1.49–7.69]) were independently associated with IVH. In the independent cohort consisting of 856 patients with mean age 71 ± 12 years (IVH in 37 %), hyperglycemia (aOR 2.23, 95 % CI [1.55–3.20]), non-lobar ICH location (aOR 2.50, 95 % CI [1.75–3.59]), and IPH volume (aOR 1.02, 95 % CI [1.01–1.02]) were associated with IVH. Conclusions: Hyperglycemia is associated with IVH and may be a peripheral marker for the inflammatory response to hemorrhage within the ventricles. Further translational studies are needed to elucidate the pathophysiological basis for this phenomenon.
AB - Objective: Acute hyperglycemia following intracerebral hemorrhage (ICH) is associated with poor functional outcomes and may result from a neuroendocrine stress response. Given the proximity of neuroendocrine structures to the cerebral ventricles, we tested the hypothesis that intraventricular hemorrhage (IVH) is associated with hyperglycemia. Materials and methods: A post-hoc analysis of the ICH Deferoxamine (i-DEF) trial was conducted to determine predictors of IVH. Variables with significant differences (p < 0.1) in univariable tests between patients with and without IVH were entered into a logistic regression model along with age, sex, diabetes, hyperglycemia (admission glucose ≥140 mg/dL), and baseline intraparenchymal hemorrhage (IPH) volume. This model was then applied to an independent cohort of consecutive non-traumatic ICH patients admitted to a single referral center (2007 to 2018). Results: Among 294 patients in the i-DEF cohort with mean age 60 ± 12 years (IVH in 41 %), hyperglycemia (aOR 1.90, 95 % CI [1.06–3.38]), smoking history (aOR 1.90, 95 % CI [1.11–3.27]), and non-lobar ICH location (aOR 3.38, 95 % CI [1.49–7.69]) were independently associated with IVH. In the independent cohort consisting of 856 patients with mean age 71 ± 12 years (IVH in 37 %), hyperglycemia (aOR 2.23, 95 % CI [1.55–3.20]), non-lobar ICH location (aOR 2.50, 95 % CI [1.75–3.59]), and IPH volume (aOR 1.02, 95 % CI [1.01–1.02]) were associated with IVH. Conclusions: Hyperglycemia is associated with IVH and may be a peripheral marker for the inflammatory response to hemorrhage within the ventricles. Further translational studies are needed to elucidate the pathophysiological basis for this phenomenon.
KW - Cerebral hemorrhage
KW - Glucose
KW - Hyperglycemia
KW - Intraventricular hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=85209952928&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2024.123320
DO - 10.1016/j.jns.2024.123320
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C2 - 39591672
AN - SCOPUS:85209952928
SN - 0022-510X
VL - 467
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
M1 - 123320
ER -