Higher Hemoglobin A1c Level Is Associated With Poor Outcome of Intracerebral Hemorrhage

Authors

Huihui Liu, Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Xia Meng, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Chun-Feng Liu, Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
David Wang, Barrow Neurological Institute Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States.Follow
Huaguang Zheng, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Hao Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Liping Liu, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yilong Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yuesong Pan, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Document Type

Article

Abstract

Pre-morbid chronic hyperglycemia is associated with the poor outcome of ischemic stroke, but the association between chronic hyperglycemia, and the long-term outcome of acute intracerebral hemorrhage is still poor understood. Data on patients with acute intracerebral hemorrhage in the ACROSS-China registry (Abnormal Glucose Regulation in Patients With Acute Stroke Across China) were reviewed. Elevated hemoglobin A1c (HbA1c) level on admission was indicative of chronic hyperglycemia. According to the clinical categories of HbA1c, patients were divided into three groups. Multivariable logistic regression or Cox method was performed to analyze the association of HbA1c and the prognosis of patients with acute intracerebral hemorrhage (poor functional outcome [modified Rankin scale score 3-6] and mortality) at 1 year. A total of 416 patients were included in this study. Fifty-two (12.5%) patients died and 130 (31.8%) had poor functional outcome at 1-year follow-up. The higher levels of HbA1c (≥6.5%) was associated with a poor functional outcome (OR 2.35, 95% CI, 1.28-4.29) and increased mortality (OR 2.63, 95% CI 1.34-5.15), compared with the lowest category. When further stratified by diabetic or non-diabetic medical history, higher HbA1c (≥6.5%) still increased the risk of poor functional outcome (OR 3.42, 95% CI 1.39-8.44) and mortality (OR 4.48, 95% CI 1.64-12.24) in patients with non-diabetic medical history. However, higher HbA1c didn't have the association with the increased risk of poor functional outcome (OR 1.06, 95% CI 0.37-3.03) and mortality (OR 1.20, 95% CI 0.39-3.72) in patients with diabetic medical history. Higher HbA1c was associated with a higher risk of death and poor functional outcome 1 year after intracerebral hemorrhage, especially in patients without a diabetic history.

Publication Date

1-1-2019

Publication Title

Frontiers in neurology

ISSN

1664-2295

Volume

10

First Page

1073

PubMed ID

31649615

Digital Object Identifier (DOI)

10.3389/fneur.2019.01073

Recommended Citation

Liu, Huihui; Meng, Xia; Liu, Chun-Feng; Wang, David; Zheng, Huaguang; Li, Hao; Liu, Liping; Wang, Yilong; Wang, Yongjun; and Pan, Yuesong, "Higher Hemoglobin A1c Level Is Associated With Poor Outcome of Intracerebral Hemorrhage" (2019). Neurology. 1790.
https://scholar.barrowneuro.org/neurology/1790