Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis

作者：Zuurbier Susanna M; Hiltunen Sini; Tatlisumak Turgut; Peters Guusje M; Silvis Suzanne M; Haapaniemi Elena; Kruyt Nyika D; Putaala Jukka; Coutinho Jonathan M^*

来源：Stroke, 2016, 47(2): 390-+.

DOI：10.1161/STROKEAHA.115.011177

• coma
• diabetes mellitus
• hyperglycemia
• risk factors
• sinus thrombosis, intracranial
• stroke

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.

• 出版日期2016-2