Effects of glucose level on early and long-term mortality after intracerebral haemorrhage: The Acute Brain Bleeding Analysis Study

Aims/hypothesis: Admission hyperglycaemia is associated with a poor outcome in patients with ischaemic stroke. However, its prognostic effects after intracerebral haemorrhage (ICH) are still unclear. Methods: We prospectively enrolled patients with ICH at 33 centres in Korea between October 2002 and March 2004. A total of 1,387 patients who had ICH and underwent brain computed tomography within 48 h of symptom onset were included in the study (n = 1,387). Clinical information and radiological findings were collected at admission. Glucose levels were examined in relation to early (up to 30 days after ictus) and long-term (after 30 days) mortality rates using Cox regression analysis. To eliminate short-term effects, long-term mortality rate analysis was performed on surviving patients for more than 30 days. Results: The long-term mortality rate was 21.1% after a mean follow-up of 434.3 ± 223.2 days and was found to increase significantly with glucose quartile (p < 0.001). Admission glucose level was an independent risk factor for early mortality (per mmol/l; adjusted HR 1.10 [95% CI 1.01-1.19]), but not for long-term mortality. Moreover, when analysis was restricted to patients without diabetes, glucose level was found to be an independent risk factor for post-ICH mortality (n = 1,119; adjusted HR 1.10 [95% CI 1.03-1.17]) and had marginal significance for early (p = 0.053) and long-term mortality (p = 0.09). Conclusions/interpretation: We found that admission glucose levels were associated with early mortality after ICH. In patients without diabetes, admission glucose levels were associated with long-term mortality. We therefore suggest that intensive lowering of glucose level should be further investigated in ICH patients.