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KMID : 1148420200030010006
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Journal of Neurointensive Care
2020 Volume.3 No. 1 p.6 ~ p.11
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Prognostic Value of Early Hyperglycemia in Neurocritically Ill Patients
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Han Jung-Hoon
Lee Yun-Im
Ryu Jeong-Am
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Abstract
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Objective: To evaluate the relationship of early hyperglycemia and neurological prognosis in neurocritically ill patients.
Methods: This was a retrospective study of adult patients admitted to the neurosurgical intensive care unit (ICU) from January 2010 to July 2019. Primary outcome was neurological status at 6-month follow-up assessed with the Glasgow Outcome Scale (GOS, 1 to 5).
Results: A total of 202 patients were analyzed in this study. Of them, 70 (34.7%) patients had early hyperglycemia (≥ 200 mg/dL within 48 hours after ICU admission). Brain tumor (39.6%) and subarachnoid hemorrhage (17.8%) were the most common reasons for ICU admission. Ninety-three (46.0%) patients had favorable neurological outcomes (GOS of 4 or 5). Poor neurological outcome was more common in the early hyperglycemia group than in the non-hypoglycemia group (71.4% vs. 44.7%, p < 0.001). In addition, 90-day mortality rate was significantly higher for patients with early hyperglycemia than that for patients without hyperglycemia (17.1% vs. 8.3%, p = 0.011). Multivariable logistic regression analysis revealed that age (adjusted odd ratio [OR]: 1.04, 95% confidence interval (CI): 1.020?1.066), Acute Physiology and Chronic Health Evaluation II score on ICU admission (adjusted OR: 1.06, 95% CI: 1.003?1.113), and early hyperglycemia (adjusted OR: 2.32, 95% CI: 1.188?4.528) were significantly associated with poor neurological outcomes in neurocritically ill patients (Hosmer-Lemeshow Chi-squared = 5.43, df = 8, p = 0.711).
Conclusions: In this study, early hyperglycemia could be a significant predictor for neurological outcome in neurocritically ill patients.
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KEYWORD
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Hyperglycemia, Intensive care unit, Prognositc Factor, Neurosurgery
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