Association of Plasma Glucose to Potassium Ratio and Mortality After Aneurysmal Subarachnoid Hemorrhage

Jung, Hyun Min; Paik, Jin Hui; Kim, Sin Young; Hong, Dae Young

doi:10.3389/fneur.2021.661689

Cited by 29 publications

(25 citation statements)

References 25 publications

(33 reference statements)

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“…Previous literature reported that higher serum GPR level at admission was significantly associated with poor outcome or mortality at 3 months following aSAH ( 17 , 18 ). However, the studies fail to answer whether the GPR levels are related to early brain injury risk.…”

Section: Discussionmentioning

confidence: 90%

“…Associations of elevated GPR levels with poor outcome and mortality have been described in patients with aSAH ( 17 , 18 ) but never concerning rebleeding occurrence. How can elevated GPR levels (increased blood glucose and decreased potassium) cause rebleeding?…”

Section: Discussionmentioning

confidence: 99%

“…reported that a high serum GPR in patients with aSAH would help predict a poor prognosis. Jung et al ( 17 )also suggested that higher plasma GPR levels on admission were considered a potential predictor of 3-month mortality in patients with aSAH. Likewise, our study demonstrated high-serum GPR level at admission in patients who developed rebleeding and was associated with unfavorable outcomes in patients with aSAH.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that a higher serum glucose-potassium ratio (GPR) level at admission was significantly associated with poor outcome or mortality at 3 months following aSAH ( 17 , 18 ). The existing literature left several crucial unanswered questions about whether the GPR was related to the risk of early brain injury.…”

Section: Introductionmentioning

confidence: 99%

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Elevated Glucose-Potassium Ratio Predicts Preoperative Rebleeding in Patients With Aneurysmal Subarachnoid Hemorrhage

et al. 2022

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Introduction: Recent reports revealed that higher serum glucose-potassium ratio (GPR) levels at admission were significantly associated with poor outcomes at 3 months following aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to investigate the association between GPR and the risk of rebleeding following aSAH.Methods: This single-center retrospective study of patients with aSAH was conducted in our hospital between January 2008 and December 2020. Patients meeting the inclusion criteria were divided into the rebleed group and the non-rebleed group. Univariate and multivariate analyses were implemented to assess the association between risk factors of rebleeding and outcomes.Results: A total of 1,367 patients experiencing aSAH, 744 patients who met the entry criteria in the study [mean age (54.89 ± 11.30) years; 60.50% female patients], of whom 45 (6.05%) developed rebleeding. The patients in the rebleed group had significantly higher GPR levels than those of patients without rebleeding [2.13 (1.56–3.20) vs. 1.49 (1.23–1.87); p < 0.001]. Multivariable analysis revealed that higher mFisher grade and GPR were associated with rebleeding [mFisher grade, odds ratios (OR) 0.361, 95% CI 0.166–0.783, p = 0.01; GPR, OR 0.254, 95% CI 0.13–0.495, p < 0.001]. The receiver operating characteristics (ROCs) analysis described that the suitable cut-off value for GPR as a predictor for rebleeding in patients with aSAH was determined as 2.09 (the area under the curve [AUC] was 0.729, 95% CI 0.696–0.761, p < 0.0001; the sensitivity was 53.33%, and the specificity was 83.98%). Pearson correlation analysis showed a significant positive correlation between GPR and mFisher grade, between GPR and Hunt–Hess grade (mFisher grade r = 0.4271, OR 0.1824, 95% CI 0.3665–0.4842, p < 0.001; Hunt–Hess grade r = 0.4248, OR 0.1836, 95% CI 0.3697–0.4854, p < 0.001). The patients in the poor outcome had significantly higher GPR levels than those of patients in the good outcome [1.87 (1.53–2.42) vs. 1.45 (1.20–1.80); p < 0.001]. Multivariable analysis demonstrated that GPR was an independent predictor for poor prognosis. The AUC of GPR was 0.709 (95% CI 0.675–0.741; p < 0.0001) (sensitivity = 77.70%; specificity = 55.54%) for poor prognosis.Conclusion: Higher preoperative serum GPR level was associated with Hunt–Hess grade, mFisher grade, rebleeding, and unfunctional outcome, and that they predicted preoperative rebleeding and the 90-days outcome of non-diabetic patients with aSAH, who had potentially relevant clinical implications in patients with aSAH.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Elevated Glucose-Potassium Ratio Predicts Preoperative Rebleeding in Patients With Aneurysmal Subarachnoid Hemorrhage

et al. 2022

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“…The relationship between admission hyperglycemia and mortality was also extensively analyzed; Bian et al demonstrated that admission BG was associated with 1-year mortality after being adjusted for other confounding factors in a study including 239 SAH patients (17). Another study from South Korea including 553 SAH patients found that BG at admission was not an independent predictor for 3-month mortality, although BG level was significantly higher in non-survivors and patients with poor outcome (18). Incidentally, there were also studies suggesting that admission hyperglycemia predicted short-term (30 days), but not long-term, mortality in SAH patients (19).…”

Section: Introductionmentioning

confidence: 99%

Admission Hyperglycemia Predicts Long-Term Mortality in Critically Ill Patients With Subarachnoid Hemorrhage: A Retrospective Analysis of the MIMIC-III Database

Tang

Zhang

2021

Front. Neurol.

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Subarachnoid hemorrhage (SAH) is a severe subtype of stroke with high mortality. Hyperglycemia is a common phenomenon in critically ill patients and associated with poor clinical outcome. However, the predictive value of admission hyperglycemia for 30 and 90-day all-cause mortality in critically ill patients with SAH remains controversial. All SAH patients between 2001 and 2012 were included based on the MIMIC-III database and were further classified according to the tertiles of blood glucose (BG) measured on intensive care unit (ICU) admission. Clinical information including demographic data, comorbidities, and laboratory indicators were exacted and analyzed. The primary outcomes were 30- and 90-day all-cause mortality. A total of 1,298 SAH patients were included. The 30 and 90-day mortality rates were 19.80% and 22.73%, respectively. Subjects in the high glucose tertile were older, were overweight, had higher sequential organ failure assessment (SOFA) and Simplified Acute Physiology Score II (SAPS II) scores, and presented higher mortality rate. Generalized additive model revealed a U-shaped relationship between BG and 30 and 90-day all-cause mortality. Furthermore, Kaplan–Meier (K-M) survival curve also illustrated that subjects with admission hyperglycemia presented lower survival rate and shorter survival time. In Cox analysis, after adjustment for potential confounders, admission hyperglycemia was related to an increase in 30- and 90-day all-cause mortality in SAH patients. In subgroup analysis, the association between admission hyperglycemia and all-cause mortality was consistent. In conclusion, admission hyperglycemia is associated with significantly increased 30- and 90-day all-cause mortality in critically ill patients with SAH.

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Development of a predictive nomogram for 28-day mortality risk in non-traumatic or post-traumatic subarachnoid hemorrhage patients

Miao,

Cai,

et al. 2023

Neurol Sci

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Association of Plasma Glucose to Potassium Ratio and Mortality After Aneurysmal Subarachnoid Hemorrhage

Cited by 29 publications

References 25 publications

Elevated Glucose-Potassium Ratio Predicts Preoperative Rebleeding in Patients With Aneurysmal Subarachnoid Hemorrhage

Elevated Glucose-Potassium Ratio Predicts Preoperative Rebleeding in Patients With Aneurysmal Subarachnoid Hemorrhage

Admission Hyperglycemia Predicts Long-Term Mortality in Critically Ill Patients With Subarachnoid Hemorrhage: A Retrospective Analysis of the MIMIC-III Database

Development of a predictive nomogram for 28-day mortality risk in non-traumatic or post-traumatic subarachnoid hemorrhage patients

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