Admission hyperglycemia as an independent predictor of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage: a single-center retrospective study
DOI:
https://doi.org/10.59156/aa77dz15Keywords:
Hyperglycemia, Mortality, Prognosis, Subarachnoid HemorrhageAbstract
Background: aneurysmal subarachnoid hemorrhage is associated with high morbidity and mortality. Admission hyperglycemia has been proposed as a prognostic marker, although its independent role is not yet fully established.
Objectives: to evaluate the association of admission hyperglycemia with in-hospital mortality and the incidence of nosocomial infections in patients with aneurysmal subarachnoid hemorrhage.
Methods: an observational, analytical, and retrospective study was conducted in a cohort of 79 patients with aSAH at a high-complexity center over a 7-year period. Hyperglycemia was defined as venous blood glucose ≥140 mg/dL. Demographic and clinical variables were analyzed. Chi-square tests and multivariate logistic regression were used to identify independent predictors of mortality.
Results: hyperglycemia was present in 54.43% of the patients. It was associated with higher mortality (44% vs. 16%, p = 0.01); and a higher rate of infections (41% vs. 19%, p = 0.03) in the hyperglycemia subgroup. Mortality was also higher in patients with a high Hunt & Hess grade (50% vs. 14%, p <0.001) and modified Fisher grade (44% vs. 14%, p = 0.003). In the multivariate analysis, hyperglycemia behaved as an independent predictor of mortality (OR 5.02; 95%, CI 1.58-15.97, p = 0.006).
Conclusions: in patients with aSAH, admission hyperglycemia is independently associated with an increase in mortality and infectious complications. Given its potentially modifiable nature, it emerges as a key therapeutic target and a valuable tool for prognostic stratification.
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