Hyperglycemia has been a point of attention over the past few years with several studies demonstrating the poor effect of elevated blood glucose on intra-cerebral, hemorrhage (ICH) outcome. In this study we tried to identify the impact of stress-induced hyperglycemia (SIH) on the outcome of patients with spontaneous ICH. Among 772 patients who developed acute ICH, only 343 patients have met the inclusion criteria for having spontaneous non-traumatic ICH. SIH was measured using the glycemic gap (GG) which measures the difference between the average pre-admission and on-admission blood glucose levels. The average pre-admission blood glucose was derived from the admission HbA1C according to the equation (28.7*HbA1c + 46.7). ROC analysis was used to determine threshold GG value that differentiate patients in regards of favorable or unfavorable outcomes. Favorable outcome was defined as patients being discharged to either home or rehabilitation facility and unfavorable outcome as being discharged to any other facility (nursing home, LTAC, hospice or patient had expired). We found that, using a cut-off GG of 30mg/dl, the incidence of SIH was 32.7% and the probability of individuals with low GG (< 30) will be discharged home or rehab was 0.79. Also, elevated GG was associated with patients’ mortality. Among patients who died or discharged to hospice the average GG was 44, compared to an average of 9.8 among patients who had survived. This study showed a strong correlation between SIH and poor outcomes among patients with spontaneous ICH as regards patient’s disposition and survival.

IMPACT OF STRESS INDUCED HYPERGLYCEMIA ON SPONTANEOUS NON-TRAUMATIC INTRACEREBRAL HEMORRHAGE OUTCOMES