Serum Glucose and Potassium Ratio as Risk Factors for Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Matano, Fumihiro; Fujiki, Yu; Mizunari, Takayuki; Koketsu, Kenta; Tamaki, Toru; Murai, Yasuo; Morita, Akio

doi:10.1016/j.jstrokecerebrovasdis.2019.03.041

Cited by 44 publications

(34 citation statements)

References 34 publications

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“…23 Matano et al reported that there was a significant correlation between cerebral vasospasm and ischemic complications occurring after SAH, and they also showed that the GLU/K ratio and serum GLU/K ratio were high in patients with poor prognosis. 24 Fujiki et al reported that a high serum GLU/K ratio in patients with aneurysmal SAH would be useful in predicting poor prognosis. 25 Park et al suggested that catecholamine crises in globus pallidus and deep white matter were key pathophysiologic factors in CO intoxication.…”

Section: Discussionmentioning

confidence: 99%

Assessment of serum glucose/potassium ratio as a predictor for delayed neuropsychiatric syndrome of carbon monoxide poisoning

et al. 2020

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Introduction: Carbon monoxide (CO) poisoning is a crucial cause of delayed neuropsychiatric syndrome (DNS). However, most biomarkers are not satisfactory for the prediction of DNS caused by CO poisoning. Thus, we evaluated the adequacy of the serum glucose/potassium (GLU/K) ratio, which may be an easy, quick, and readily available parameter that can be used in the emergency department for predicting DNS. Methods: We evaluated 281 patients who were admitted to our emergency department between January 2012 and December 2018. The patients were divided into two groups: DNS (+) and DNS (−). The GLU/K was compared for the groups. Results: Glucose, blood urea nitrogen, carboxyhemoglobin, and GLU/K ratios of patients in the DNS (+) group were statistically significantly higher than those patients in DNS (−) group (140 ± 34 vs. 110 ± 24, p < 0.001; 17.58 ± 6.14 vs. 14.27 ± 5.08, p = 0.003; 29 ± 5.1 vs. 18.9 ± 7.6, p < 0.001; and 38.35 ± 10.11 vs. 28.65 ± 6.53, p < 0.001, respectively). The area under the curve for GLU/K to predict DNS was measured as 0.791, and 35.9 as a cut-off value had 63.6% sensitivity and 89.6% specificity. Conclusions: DNS development in CO poisoning is a serious and feared complication. We suggest that the GLU/K ratio has a high potential as a rapid, easy preliminary marker for the exclusion of patients who will not subsequently develop DNS.

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Section: Discussionmentioning

confidence: 99%

Assessment of serum glucose/potassium ratio as a predictor for delayed neuropsychiatric syndrome of carbon monoxide poisoning

et al. 2020

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“…A review study investigating hemostatic or fibrinolytic parameters that may predict DCI also reported that levels of von Willebrand factor and platelet activating factor were higher in SAH patients with DCI than in those without DCI [4]. Recent evidence of serum parameters that serve as biomarkers for predicting SAH outcomes suggests that various inflammatory, fibrinolytic and hematologic factors may be associated with poor outcomes after SAH, including elevated glucose level [11], low platelet count [12], elevated CRP [13][14][15], and white blood cell (WBC) count [15,16].…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

Associations between C-reactive protein and white blood cell count, occurrence of delayed cerebral ischemia and poor outcome following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis

Zhang

2021

Acta Neurol Belg

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This review and meta-analysis investigated associations of systemic inflammatory marker C-reactive protein (CRP) and white blood cell count (WBC) with occurrence of delayed cerebral ischemia (DCI) and poor functional outcome after aneurysmal subarachnoid hemorrhage (aSAH). Pubmed, EMBASE, and CENTRAL databases were searched until November 30, 2019, selecting prospective and retrospective studies of patients with spontaneous SAH due to ruptured aneurysm. Outcome measures were occurrence of DCI, defined as new focal neurological deficit or a deterioration of consciousness; and/or a new infarct on computed tomography or magnetic resonance imaging that was not visible initially. Occurrence of poor functional outcome at follow-up were measured by modified Rankin Scale or Glasgow outcomes scale. Fifteen studies analyzing data of 3268 patients with aSAH were included. Meta-analysis revealed early increase in CRP was significantly associated with higher risk of occurrence of DCI (pooled OR 1.30, 95% CI 1.10-1.54; P = 0.002), whereas not with poor functional outcome (pooled OR 1.02, 95% CI 1.00-1.04, P = 0.052). No significant associations between early increase in WBC and DCI (pooled OR 1.13, 95% CI 0.95-1.34; P = 0.179) were observed, whereas increase in WBC was significantly associated with increased risk of poor functional outcome (pooled OR 1.17, 95% CI 1.07-1.28, P = 0.001). Early increase in blood CRP appears to correlate with DCI after SAH, while increase in WBC correlates with poor functional outcome. However, strong conclusion cannot be made due to the small study number, between-study heterogeneity and suspicion of uncontrolled factors. Whether early phase CRP and WBC may serve as prognostic markers for aSAH needs more investigation.

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“…8 Additionally, these changes have been found in some diseases involving acute brain injury, such as severe traumatic brain injury and aneurysmal subarachnoid hemorrhage. [9][10][11] The serum glucose/potassium ratio (GPR) is calculated as the serum glucose level divided by the serum potassium level. Its elevation has been reported to be highly associated with increasing severity and poor prognosis of certain pathological conditions, e.g., carbon monoxide poisoning.…”

Section: Introductionmentioning

confidence: 99%

Serum glucose and potassium ratio as a predictive factor for prognosis of acute intracerebral hemorrhage

Zhuang

Cai

et al. 2021

J Int Med Res

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Objective The serum glucose/potassium ratio (GPR) is a potential prognostic predictor for acute brain injury-related diseases. We calculated the serum GPR in patients with acute intracerebral hemorrhage (ICH) and explored its prognostic value for long-term prognoses and ICH severity. Methods This retrospective cohort study consecutively included 92 patients with ICH and 92 healthy controls. The National Institutes of Health Stroke Scale (NIHSS) score, Glasgow coma scale (GCS) score, and hematoma volume were used to assess severity. A modified Rankin Scale score > 2 at 90 days post-stroke was defined as a poor outcome. Results The serum GPR was significantly higher in patients than controls. The serum GPR was weakly correlated with the NIHSS score, GCS score, and hematoma volume. The serum GPR, GCS score, and hematoma volume were independently associated with poor outcomes. In the receiver operating characteristic curve analysis, the serum GPR remarkably discriminated patients at risk of poor outcomes at 90 days. The serum GPR significantly improved the prognostic predictive capability of hematoma volume and tended to increase that of the GCS score. Conclusion Serum GPR is an easily obtained clinical variable for predicting clinical outcomes after ICH.

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Serum Glucose and Potassium Ratio as Risk Factors for Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Cited by 44 publications

References 34 publications

Assessment of serum glucose/potassium ratio as a predictor for delayed neuropsychiatric syndrome of carbon monoxide poisoning

Assessment of serum glucose/potassium ratio as a predictor for delayed neuropsychiatric syndrome of carbon monoxide poisoning

Associations between C-reactive protein and white blood cell count, occurrence of delayed cerebral ischemia and poor outcome following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis

Serum glucose and potassium ratio as a predictive factor for prognosis of acute intracerebral hemorrhage

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