Abstract HUP4: The Relationship Between Stress-induced Hyperglycemia and the Prognosis of Subarachnoid Hemorrhage: A Study Based on the Chinese Stroke Center Alliance

Background: Subarachnoid Hemorrhage (SAH) represents a serious and frequently fatal disease, now recognized as a profound threat to global public health. However, the correlation between stress hyperglycemia ratio (SHR), glycemic gap (GG), and SAH prognosis remains undefined. Methods: This research utilized data from the Chinese Stroke Center Alliance Study. Stress-induced hyperglycemia was assessed using GG and SHR. The study population was divided into four groups based on the quartiles of SHR and GG. The primary outcome was the Modified Rankin Scale (mRS) score at discharge; a discharge mRS score ≥2, including death, denoted a poor outcome. Results: 3,812 SAH patients were included in the study. After multivariate adjustment, each standard deviation increase in SHR was associated with an increased risk of poor outcomes (OR=1.15, 95%CI: 1.06-1.25, P<0.05), indicating that higher SHR levels were associated with greater risk. When using the categorical quartile method, compared to group Q1, the risk of poor outcomes in group Q4 was significantly higher (OR=1.45, 95%CI: 1.17-1.79, P<0.05). Similarly, each standard deviation increase in GG was associated with an increased risk of poor outcomes (OR=1.10, 95%CI: 1.02-1.19, P<0.05), with higher GG levels also associated with greater risk. Compared to group Q1, the risk of poor outcomes in group Q4 was more significant (OR=1.36, 95%CI: 1.10-1.69, P<0.05). Conclusion: This research reveals that stress hyperglycemia upon hospital admission, as indicated by elevated SHR and GG, is associated with poor outcomes in SAH patients. This association was particularly pronounced in women, individuals aged over 65 years, and those undergoing endovascular embolization or nimodipine therapy.