The Influence Of Glucose Coefficient Of Variation On The Mortality Of Subarachnoid Hemorrhage

Objective: To investigate the relationship between the blood glucose variability and the mortality of severe subarachnoid hemorrhage patients,provide some guidance for blood glucose monitoring and control in patients with subarachnoid hemorrhage.Methods: A retrospective study involving 86 subarachnoid hemorrhage patients admitted to intensive care unit from January2008 toDecember2013 wasconducted.Excluding pancreatitis,with history of diabetes,glycosylated hemoglobin(HbA1C)? 6.5%,traumatic subarachnoid hemorrhage,ICU hospital stay less than 72 hours and incomplete information.The clinical data of these patients(Including age,gender,smoking history,GCS score,Fisher and Hunt – Hess grading APACHE-II score)were recorded,and the 30 days survival situation after hospital admission.The mean blood glucose(GluAve),blood glucose standard deviation(GluSD),and blood glucose coefficient of variation(GluCV)were calculated by monitoring the peripheral blood glucose and recording all blood glucose values at 72 hour for each patient.Patients were divided into non-survivor group(n=28)and survivor group(n=58),according to the 30-day outcome after admission.The values of GluCV and APACHE-II score were compared between the two groups.patients were divided into four groups according to the levels of GluCV(<15%,15%-30%,3O%-50%,>50%).The values of APACHE-II score and mortality were compared between the four groups.Results: The level of APACHE-II score in non-survivor group were significantly higher than that of the survivor group [(22.46±4.32)vs.(16.18±2.08),P<0.01].The level of GluCV in nonsurvivor group were significantly higher than that of the survivor group[(34.15±9.25)vs.(22.59±11.96),P<0.01].With the gradual increase of GluCV,APACHE-II score and mortality were increased significantly.[APACHE-II score(score):15.59±1.99,19.92±2.88,22.34±6.13,25.34±3.61,P for trend<0.01;30-daymortality:10.44%,20.03%,34.02%,44.03%,P for trend<0.01]?Conclusion: The levels of glucose coefficient of variation are significantly correlated with the mortality of patients with acute subarachnoid hemorrhage.