Early hyperglycaemia and the early‐term death in patients with spontaneous intracerebral haemorrhage: a meta‐analysis

Abstract

Background and Aims Stroke is often accompanied by hyperglycaemia, and this has an important impact on prognosis. The aim of this study was to investigate the relationship between early hyperglycaemia and the outcome of spontaneous intracerebral haemorrhage (sICH). Methods A systematic literature search on PubMed, Embase, Cochran, WANFANG DATA, VIP and CNKI databases was conducted, and eight eligible studies were retrieved. Relative risks and 95% confidence interval (CI) in the hyperglycaemia group compared with the non‐hyperglycaemia group were calculated and meta‐analysed when possible. Results Eight controlled trials and cohort studies totalling 3756 patients addressing early hyperglycaemia and the outcome of sICH were compiled for this meta‐analysis. Cut‐off points for defining hyperglycaemia was 6.1–8.3 mmol/L, and the median cut‐off value was 7.5 mmol/L. Studies were assigned to one of the two subgroups: the group A (for studies with the values of glucose concentrations above the median cut‐off) and the group B (for studies with the values of glucose concentrations below the median cut‐off). The RR for short‐term death associated with hyperglycaemia was 3.65 (95% confidence interval (CI) (3.08, 4.33); P < 0.0001). In the subgroup analysis, the relative risk values were 3.46 (95% CI (1.66, 7.20); P = 0.0009) and 3.53 (95% CI (2.92, 4.26); P < 0.00001) for the groups A and B respectively. The publication bias showed that Egger's test (P > 0.1), Begg's test (P > 0.05) and Nfs_0.05 exceeded included studies. Conclusions Early hyperglycaemia can significantly increase the rate of early‐term death in patients with sICH, independent of the cut‐off points for hyperglycaemia.