Serum Glucose and Potassium Ratio as Risk Factors for Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage.


Journal

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 30 10 2018
revised: 14 01 2019
accepted: 16 03 2019
pubmed: 8 5 2019
medline: 23 7 2019
entrez: 8 5 2019
Statut: ppublish

Résumé

Cerebral vasospasm is associated with poor prognosis in patients with aneurysmal subarachnoid hemorrhage (SAH), and biomarkers for predicting poor prognosis have not yet been established. We attempted to clarify the relationship between serum glucose/potassium ratio and cerebral vasospasm in patients with aneurysmal SAH. We studied 333 of 535 aneurysmal SAH patients treated between 2006 and 2016 (123 males, 210 females; mean age 59.7 years; range 24-93). We retrospectively analyzed the relationship between cerebral vasospasm grade and clinical risk factors, including serum glucose/potassium ratio. Postoperative angiography revealed cerebral vasospasm in 112 patients (33.6%). Significant correlations existed between the ischemic complication due to cerebral vasospasm and glucose/potassium ratio (P < .0001), glucose (P = .016), and potassium (P = .0017). Serum glucose/potassium ratio was elevated in the cerebral vasospasm grade dependent manner (Spearman's r = 0.1207, P = .0279). According to the Glasgow Outcome Scale (GOS) score at discharge, 185 patients (55.5%) had a poor outcome (GOS scores 1-3). Serum glucose/potassium ratio was significantly correlated between poor outcome (GOS scores 1-3) and age (P < .0001), serum glucose/potassium ratio (P < .0001), glucose (P < .0001), potassium (P = .0004), white blood cell count (P = .0012), and cerebral infarction due to cerebral vasospasm (P < .0001). Multivariate logistic regression analyzes showed significant correlations between cerebral infarction due to cerebral vasospasm and serum glucose/potassium ratio (P = .018), glucose (P = .027), and potassium (P = .052). Serum glucose/potassium ratio in cases of aneurysmal SAH was significantly associated with cerebral infarction due to cerebral vasospasm and GOS at discharge. Therefore, this factor was useful to predict prognosis in patients with cerebral vasospasm and aneurysmal SAH.

Identifiants

pubmed: 31060790
pii: S1052-3057(19)30136-3
doi: 10.1016/j.jstrokecerebrovasdis.2019.03.041
pii:
doi:

Substances chimiques

Biomarkers 0
Blood Glucose 0
Potassium RWP5GA015D

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1951-1957

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Fumihiro Matano (F)

Department of Neurosurgery, Tama Nagayama Hospital, Tokyo, Japan. Electronic address: s00-078@nms.ac.jp.

Yu Fujiki (Y)

Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.

Takayuki Mizunari (T)

Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan.

Kenta Koketsu (K)

Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan.

Tomonori Tamaki (T)

Department of Neurosurgery, Tama Nagayama Hospital, Tokyo, Japan.

Yasuo Murai (Y)

Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan.

Hiroyuki Yokota (H)

Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.

Akio Morita (A)

Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan.

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