Increased Short-Term Mortality in Patients with Spontaneous Intracerebral Hemorrhage and its Association with Admission Glucose Levels and Leukocytosis

Abstract

OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) can be a devastating event. An increased glucose level in patients with ICH is known to be related to poor outcomes, including acute leukocytosis, which is a wellestablished response to ICH. The purpose of this study was to evaluate the association between admission laboratory factors and 3-month mortality in patients with spontaneous supratentorial ICH. METHODS: We performed a Kaplan-Meier analysis to evaluate the risk factors for 3-month mortality in patients with ICH. We used univariate and multivariate Cox regression analyses to calculate hazard ratios with 95% confidence intervals for short-term mortality based on clinical and laboratory factors. The area under the receiver operating characteristic curve was used to determine the laboratory risk factors that predicted mortality. RESULTS: In total, 538 patients from our hospital admitted with primary spontaneous supratentorial ICH over an 8-year period were enrolled in this study. Higher leukocyte counts (hazard ratio, 1.019-95% confidence interval, 1.012-1.027; P < 0.001) and glucose levels on admission were associated with higher 3-month mortality. The receiver operating characteristic curve analysis showed that the areas under the curve of ICH volume, glucose, and leukocyte counts were 0.696 (cutoff value, 41.63), 0.687 (cutoff value, 134), and 0.642 (cutoff value, 9.4), respectively. CONCLUSIONS: Higher admission white blood cell counts and glucose levels were associated with higher 3-month mortality in patients with spontaneous ICH. These data show that an altered glucose metabolism and inflammatory state after ICH may be related to early deterioration after an ICH.