Value of Glycemic Indices for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: A Retrospective Single-Center Study

Bibliographic Details
Title: Value of Glycemic Indices for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage: A Retrospective Single-Center Study
Authors: Matthias Manfred Deininger, Miriam Weiss, Stephanie Wied, Alexandra Schlycht, Nico Haehn, Gernot Marx, Anke Hoellig, Gerrit Alexander Schubert, Thomas Breuer
Source: Brain Sciences, Vol 14, Iss 9, p 849 (2024)
Publisher Information: MDPI AG, 2024.
Publication Year: 2024
Collection: LCC:Neurosciences. Biological psychiatry. Neuropsychiatry
Subject Terms: aneurysmal subarachnoid hemorrhage, delayed cerebral ischemia, blood glucose, dysglycemia, hyperglycemia, hypoglycemia, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
More Details: Delayed cerebral ischemia (DCI) is a severe complication following aneurysmal subarachnoid hemorrhage (aSAH), linked to poor functional outcomes and prolonged intensive care unit (ICU) stays. Timely DCI diagnosis is crucial but remains challenging. Dysregulated blood glucose, commonly observed after aSAH, may impair the constant glucose supply that is vital for brain function, potentially contributing to DCI. This study aimed to assess whether glucose indices could help identify at-risk patients and improve DCI detection. This retrospective, single-center observational study examined 151 aSAH patients between 2016 and 2019. Additionally, 70 of these (46.4%) developed DCI and 81 did not (no-DCI). To determine the value of glycemic indices for DCI, they were analyzed separately in patients in the period before (pre-DCI) and after DCI (post-DCI). The time-weighted average glucose (TWAG, p = 0.024), mean blood glucose (p = 0.033), and novel time-unified dysglycemic rate (TUDR140, calculated as the ratio of dysglycemic to total periods within a glucose target range of 70–140 mg/dL, p = 0.042), showed significantly higher values in the pre-DCI period of the DCI group than in the no-DCI group. In the time-series analysis, significant increases in TWAG and TUDR140 were observed at the DCI onset. In conclusion, DCI patients showed elevated blood glucose levels before and a further increase at the DCI onset. Prospective studies are needed to confirm these findings, as this retrospective, single-center study cannot completely exclude confounders and limitations. In the future blood glucose indices might become valuable parameters in multiparametric models to identify patients at risk and detect DCI onset earlier.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2076-3425
Relation: https://www.mdpi.com/2076-3425/14/9/849; https://doaj.org/toc/2076-3425
DOI: 10.3390/brainsci14090849
Access URL: https://doaj.org/article/8bcfb3466f4f43ff92be58b1d17e317e
Accession Number: edsdoj.8bcfb3466f4f43ff92be58b1d17e317e
Database: Directory of Open Access Journals
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More Details
ISSN:20763425
DOI:10.3390/brainsci14090849
Published in:Brain Sciences
Language:English