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

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...

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Bibliographic Details
Published in:	Brain sciences Vol. 14; no. 9; p. 849
Main Authors:	Deininger, Matthias Manfred, Weiss, Miriam, Wied, Stephanie, Schlycht, Alexandra, Haehn, Nico, Marx, Gernot, Hoellig, Anke, Schubert, Gerrit Alexander, Breuer, Thomas
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 01-09-2024 MDPI
Subjects:	Aneurysm aneurysmal subarachnoid hemorrhage Blood glucose Blood levels Blood sugar Cerebral ischemia delayed cerebral ischemia dysglycemia Germany Glucose Health aspects Hemorrhage Hospitals Hyperglycemia Hypertension Hypoglycemia Ischemia Mortality Patients Stroke (Disease) Subarachnoid hemorrhage Germany blood glucose hyperglycemia aneurysmal subarachnoid hemorrhage hypoglycemia TUDR ICU DCI delayed cerebral ischemia dysglycemia TWAG
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Summary:	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, = 0.024), mean blood glucose ( = 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, = 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2076-3425 2076-3425
DOI:	10.3390/brainsci14090849