Persistent hyperglycemia is associated with increased mortality after intracerebral hemorrhage

Background--hyperglycemia may be associated with worse outcome after intracerebral hemorrhage (ich). we assessed the association of early glycemic trajectory on ich mortality and edema growth. methods and results--we included patients from the helsinki ich study with glucose measurements at least once between both 0 to 24 and 24 to 72 hours from onset. hyperglycemia was defined as blood glucose ≥ 8 mmol/l (144 mg/dl) based on the local threshold for treatment. glycemic trajectory was defined on maximum values 0 to 24 and 24 to 72 hours after ich: (1) persistent normoglycemia in both epochs; (2) late hyperglycemia (only between 24 and 72 hours); (3) early hyperglycemia (only before 24 hours); and (4) persistent hyperglycemia in both epochs. logistic regression with known predictors of outcome estimated the association of glycemic trajectory and 6-month mortality. a generalized linear model assessed the association of glycemic trajectory and interpolated 72-hour edema extension distance. a total of 576 patients met eligibility criteria,of whom 214 (37.2%) had persistent normoglycemia,44 (7.6%) late hyperglycemia,151 (26.2%) early hyperglycemia,and 167 (29.0%) persistent hyperglycemia. six-month mortality was higher in the persistent (51.1%) and early (26.3%) hyperglycemia groups than the normoglycemia (19.0%) and late hyperglycemia (3.6%) groups. persistent hyperglycemia was associated with 6-month mortality (odds ratio 3.675,95% ci 1.989-6.792; p < 0.001). both univariate (p=0.426) and multivariable (p=0.493) generalized linear model analyses showed no association between glycemic trajectory and 72-hour edema extension distance. conclusion--early hyperglycemia after ich is harmful if it is persistent. strategies to achieve glycemic control after ich may influence patient outcome and need to be assessed in clinical trials. © 2017 the authors and medtronic.