High blood glucose variability may predict poor outcomes in patients with spontaneous cerebellar hemorrhage undergoing surgical operation: a retrospective study

TL;DR

High blood sugar fluctuations in the first week after surgery for cerebellar hemorrhage are linked to worse outcomes six months later.

Contribution

This study shows that blood glucose variability is an independent predictor of poor outcomes in patients with spontaneous cerebellar hemorrhage undergoing surgery.

Findings

High BG variability (SD > 1.736) was associated with 4.7 times higher odds of poor outcomes.

BG variability had high sensitivity (90.3%) and specificity (83.3%) in predicting poor outcomes.

Hematoma volume and GCS score were also significant predictors of outcomes.

Abstract

Elevated blood glucose (BG) variability has been reported as an independent risk factor for poor prognosis in a variety of diseases. This study aimed to investigate the association between BG variability and clinical outcomes in patients with spontaneous cerebellar hemorrhage (SCH) undergoing surgical operation.

This retrospective cohort study of the consecutive patients admitted to the department of Neurosurgery, the Affiliated Hospital of Qingdao University between January 2014 and June 2022 with the diagnosis of SCH underwent surgical intervention. BG analysis was continuously and routinely performed. BG variability was represented by the standard deviation (SD) of the serial measurements within the first 7 days. The general characteristics, imageological information, blood glucose level, and surgical information were reviewed and compared through medical records.

A total of 115 patients (65 male and 50 female) were enrolled. Out of all 115 patients, the overall clinical outcomes according to the modified Rankin Scale (mRS) were poor (mRS 3–6) in 31 patients (26.96%) and good (mRS 0–2) in 84 patients (73.04%). Twelve of the 115 patients died during hospitalization, and the mortality rate was 10.43%. Multivariate logistic regression analysis showed that SD of BG (odds ratio (OR), 4.717; 95% confidence interval (CI), 1.054–21.115; P = 0.043), GCS (OR, 0.563; 95% CI, 0.330–0.958; P = 0.034), and hematoma volume (OR, 1.395; 95% CI, 1.118–1.748; P = 0.003) were significant predictors. The area under the ROC curve of SD of BG was 0.911 (95% CI, 0.850–0.973; P < 0.001) with a sensitivity and specificity of 90.3% and 83.3%, respectively, and the cut-off value was 1.736.

High BG Variability is independently correlated with the 6-month poor outcomes in patients with SCH undergoing surgical operation.

The online version contains supplementary material available at 10.1186/s12883-024-03758-1.

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