Title:Association between HbA1C (Glycated Hemoglobin) and Clinical Outcomes in Patients with Subarachnoid Hemorrhage After Neuro-intervention
Volume: 18
Issue: 1
Author(s): Chan W. Park , Ho J. Yi*, Dong H. Lee and Jae H. Sung
Affiliation:
- Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,Korea
Keywords:
Aneurysm, glucose, glycated hemoglobin, hyperglycemia, subarachnoid hemorrhage, HbA1C.
Abstract:
Objective: Our study investigated the association between the level of HbA1c (glycated
hemoglobin) at admission and the prognosis of aneurysmal subarachnoid hemorrhage (SAH).
Methods: A total of 510 patients treated with neuro-intervention for aneurysmal SAH and with data
for admission HbA1c (glycated hemoglobin) were included. Favorable clinical outcome was
defined as modified Rankin Scale (mRS) score of 0-2 at 3 months. Receiver operating characteristic
(ROC) curve analysis was used to identify the optimal cutoff value of HbA1C for unfavorable
clinical outcomes. Logistic regression was used to evaluate the association between HbA1C level
and outcomes.
Results: The optimal cutoff value of HbA1C was identified as 6.0% (P < 0.001), and patients with
a high HbA1C (≥ 6.0%) had a lower prevalence of favorable clinical outcomes than patients with
low HbA1C (< 6.0%) (P < 0.001). High HbA1C (≥ 6.0%) was independently associated with unfavorable
clinical outcome (OR 2.84; 95% CI: 1.52-5.44; P = 0.004). The risk of unfavorable clinical
outcome was significantly increased in patients with HbA1C (≥ 7.0%, < 8%) and HbA1C (≥ 8.0%)
compared with lower baseline HbA1C (≥ 6.0%, < 7%) values (OR 2.17; 95% CI: 1.87-5.13; P =
0.011 and OR 4.25; 95% CI: 3.17-8.41; P = 0.005).
Conclusion: Our study showed that HbA1C could be an independent predictor of worse outcomes
following neuro-intervention for aneurysmal SAH. High HbA1C (≥ 6.0%) was associated with unfavorable
clinical outcomes, and gradual elevation of HbA1C contributed to an increase in the risk
of worse clinical outcomes after SAH.
