Hyperglycemia is independently associated with decreased survival after aneurysmal subarachnoid hemorrhage in Mexican patients

Background: Hyperglycemia at admission has been recognized as an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage (aSAH); however, it remains poorly characterized in multivariate models depicting representative population samples. Objective: The objective of the study was to identify if admission blood glucose can independently predict in-hospital mortality after subarachnoid hemorrhage in Mexican patients included in a nationwide multicenter registry. Design/methods: Consecutive patients with aSAH due to ruptured intracranial aneurysm confirmed by 4-vessel angiography were registered in 25 tertiary referral centers from 14 states in Mexico. Multivariate analyses were modeled to find independent predictors of in-hospital mortality, with adjustment for relevant confounders, using the Hunt-Hess and Fisher scales. Results: A total of 231 patients were studied (66% women; mean age 52 years, range 16-90). Length of hospital stay was a median of 23 days (range 2-98) with in-hospital mortality of 20%, 54% due to a neurological cause. Survival analyses showed a higher probability of death with admittance blood glucose levels in the higher quartile (glycemia > 150 mg/dl) (p < 0.001). Predictors of in-hospital mortality were the Hunt-Hess score > 2 (odds ratio [OR]: 3.79, 95% confidence interval [CI]: 1.43-10.06) and glycemia in the higher quartile (OR: 2.98, 95% CI: 1.12-796). Conclusions: Hyperglycemia is an important independent factor associated with in-hospital mortality. Its early detection and management should be a priority to improve outcomes.