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Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis

Artikel i vetenskaplig tidskrift
Författare S. M. Zuurbier
S. Hiltunen
Turgut Tatlisumak
G. M. Peters
S. M. Silvis
E. Haapaniemi
N. D. Kruyt
J. Putaala
J. M. Coutinho
Publicerad i Stroke
Volym 47
Nummer/häfte 2
Sidor 390-+
ISSN 0039-2499
Publiceringsår 2016
Publicerad vid Institutionen för neurovetenskap och fysiologi
Sidor 390-+
Språk en
Länkar dx.doi.org/10.1161/strokeaha.115.01...
Ämnesord coma, diabetes mellitus, hyperglycemia, risk factors, sinus thrombosis, intracranial, stroke, intensive insulin therapy, critically-ill patients, dural sinus, thrombosis, intracerebral hemorrhage, stress hyperglycemia, stroke, trial, prognosis, glucose, vein, Neurosciences & Neurology, Cardiovascular System & Cardiology
Ämneskategorier Kardiovaskulär medicin, Neurovetenskaper

Sammanfattning

Background and Purpose-Admission hyperglycemia is associated with poor clinical outcome in ischemic and hemorrhagic stroke. Admission hyperglycemia has not been investigated in patients with cerebral venous thrombosis. Methods-Consecutive adult patients with cerebral venous thrombosis were included at the Academic Medical Center, The Netherlands (2000-2014) and the Helsinki University Central Hospital, Finland (1998-2014). We excluded patients with known diabetes mellitus and patients without known admission blood glucose. We defined admission hyperglycemia as blood glucose >= 7.8 mmol/L (141 mg/dL) and severe hyperglycemia as blood glucose >= 11.1 mmol/L (200 mg/dL). We used logistic regression analysis to determine if admission hyperglycemia was associated with modified Rankin Scale (mRS) score of 3 to 6 or mortality at last follow-up. We adjusted for: age, sex, coma, malignancy, infection, intracerebral hemorrhage, deep cerebral venous thrombosis, and location of recruitment. Results-Of 380 patients with cerebral venous thrombosis, 308 were eligible. Of these, 66 (21.4%) had admission hyperglycemia with 8 (2.6%) having severe admission hyperglycemia. Coma (31.3% versus 5.0%, P<0.001) and intracerebral hemorrhage (53.0% versus 32.6%, P=0.002) at presentation were more common among patients with admission hyperglycemia than normoglycemic patients. Patients with admission hyperglycemia had a higher risk of mRS score of 3 to 6 (adjusted odds ratio, 3.10; 95% confidence interval, 1.35-7.12) and mortality (adjusted odds ratio, 4.13; 95% confidence interval, 1.41-12.09). Severe hyperglycemia was even more strongly associated with mRS score of 3 to 6 (adjusted odds ratio, 11.59; 95% confidence interval, 1.74-77.30) and mortality (adjusted odds ratio, 33.36; 95% confidence interval, 3.87-287.28) compared with normoglycemic patients. Conclusions-Admission hyperglycemia is a strong predictor of poor clinical outcome in patients with cerebral venous thrombosis.

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