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

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机构: [1]Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China [2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [3]China National Clinical Research Center for Neurological Diseases, Beijing, China [4]Barrow Neurological Institute Dignity Health, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, United States
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关键词: chronic hyperglycemia diabetes mellitus hemoglobin A1c intracerebral hemorrhage outcome

摘要:
Background: 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. Methods: 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. Results: 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. Conclusions: 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. © Copyright © 2019 Liu, Meng, Liu, Wang, Zheng, Li, Liu, Wang, Wang and Pan.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
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出版当年[2017]版:
Q2 NEUROSCIENCES Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q2 CLINICAL NEUROLOGY Q3 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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通讯机构: [2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [3]China National Clinical Research Center for Neurological Diseases, Beijing, China
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