Hyperglycemia after SAH: Predictors, associated complications, and impact on outcome

Jennifer A. Frontera, Andres Fernandez, Jan Claassen, Michael Schmidt, H. Christian Schumacher, Katja Wartenberg, Richard Temes, Augusto Parra, Noeleen D. Ostapkovich, Stephan A. Mayer

Research output: Contribution to journalArticlepeer-review

165 Scopus citations


Background and Purpose - Hyperglycemia is common after subarachnoid hemorrhage (SAH). The extent to which prolonged hyperglycemia contributes to in-hospital complications and poor outcome after SAH is unknown. Methods - We studied an inception cohort of 281 SAH patients with an initial serum glucose level obtained within 3 days of SAH onset and who had at least 7 daily glucose measurements between SAH days 0 and 10. We defined mean glucose burden (GB) as the average peak daily glucose level >5.8 mmol/L (105 mg/dL). Hospital complications were recorded prospectively, and 3-month outcome was assessed with the modified Rankin scale. Results - The median GB was 1.8 mmol/L (33 mg/dL). Predictors of high-GB included age ≥54 years, Hunt and Hess grade III-V, poor Acute Physiology and Chronic Health Evaluation (APACHE)-2 physiological subscores, and a history of diabetes mellitus (all P≤0.001). In a multivariate analysis, GB was associated with increased intensive care unit length of stay (P=0.003) and the following complications: congestive heart failure, respiratory failure, pneumonia, and brain stem compression from herniation (all P<0.05). After adjusting for Hunt-Hess grade, aneurysm size, and age, GB was an independent predictor of death (odds ratio, 1.10 per mmol/L; 95% CI, 1.01 to 1.21; P=0.027) and death or severe disability (modified Rankin scale score of 4 to 6; odds ratio, 1.17 per mmol/L; 95% CI 1.07 to 1.28, P<0.001). Conclusions - Hyperglycemia after SAH is associated with serious hospital complications, increased intensive care unit length of stay, and an increased risk of death or severe disability.

Original languageEnglish (US)
Pages (from-to)199-203
Number of pages5
Issue number1
StatePublished - Jan 2006
Externally publishedYes


  • Hyperglycemia
  • Outcome
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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