125 Stress-induced Hyperglycemia Predicts Poor Outcomes in Primary ICH Patients Independently of Pre-existing Diabetes: an Observational Retrospective Analysis

INTRODUCTION: Stress-induced hyperglycemia (SIH) independently predicts poor outcomes in patients with primary intracerebral hemorrhage (ICH). However, no studies have directly compared outcomes between primary ICH patients with SIH to those with pre-existing diabetes mellitus (DM). This makes it difficult to discern whether adverse outcomes are related to sympathetic dysregulation that occurs as a sequela of SIH or secondary to chronic endothelial dysfunction in DM. METHODS: We collected data for 814 patients with a primary diagnosis of ICH who presented to Stony Brook Hospital from January 2011 to December 2022. Data regarding admission glucose, pre-existing DM, inpatient mortality, modified Rankin scale (mRS) and Glasgow Coma Scale (GCS) scores at discharge were available for 636 patients. Three groups of ICH patients were then defined: (1) non-diabetic patients with SIH, (2) diabetic patients with SIH and (3) diabetic patients without SIH. Regression models were used to compare outcomes between each group with a fourth control group of non-diabetic patients without SIH. RESULTS: A logistic regression model demonstrated that the two groups with SIH had higher inpatient mortality rates (p<0.001). A strong association with lower GCS and higher mRS scores at discharge was also seen in both SIH groups in another regression model (p<0.001). Both of these associations were independent of the presence of DM. CONCLUSIONS: In conclusion, this study found that SIH predicts poor outcomes in ICH patients regardless of their history of DM. To develop a more thorough understanding of the effects of DM and SIH in the role of ICH, there is a need for larger-scale prospective studies evaluating how changes in serum glucose during hospital stay in response to different forms of medical management are associated with long-term outcomes.