Meta-analysis links high acute glycemic variability to increased short-term mortality in subarachnoid hemorrhage patients
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Key Takeaway
Consider that high acute glycemic variability is associated with increased short-term mortality in subarachnoid hemorrhage patients.
This meta-analysis examined the relationship between acute glycemic variability and short-term mortality in adult patients hospitalized with subarachnoid hemorrhage. The analysis included 10,119 patients and utilized random-effects models to account for heterogeneity across studies. The primary outcome assessed was mortality within 90 days of the event.
The pooled results demonstrated that high acute glycemic variability was significantly associated with increased short-term mortality. The overall odds ratio was 1.64, with a 95% confidence interval of 1.34 to 2.01. Approximately 2,485 patients, representing 24.6% of the cohort, died within 90 days.
Subgroup analysis revealed that the association was stronger for patients with glucose monitoring lasting more than three days compared to those monitored for three days or less. The odds ratio was 2.62 for the longer monitoring duration versus 1.48 for the shorter duration. The p-value for this subgroup difference was 0.03. Safety data, adverse events, and discontinuations were not reported in the source material. Funding sources and conflicts of interest were not reported. The authors note that prolonged glucose monitoring may enhance prognostic value, but causation cannot be inferred from these pooled observational results.
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View Original Abstract ↓
BackgroundAcute glycemic variability (GV) has been proposed as a potential prognostic marker in critically ill patients, but its association with mortality in subarachnoid hemorrhage (SAH) remains unclear. We conducted a meta-analysis to evaluate the relationship between acute GV and short-term mortality in patients with SAH.MethodsPubMed, Embase, Web of Science, Wanfang, and CNKI were searched from inception to identify longitudinal observational studies assessing acute GV during hospitalization and reporting short-term mortality (≤90 days) in adult patients with SAH. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random-effects models accounting for the influence of potential heterogeneity.ResultsSeven cohort studies involving 10,119 patients were included, among whom 2,485 (24.6%) died within 90 days. Pooled results suggested that high acute GV was significantly associated with increased short-term mortality (OR 1.64, 95% CI 1.34–2.01; p 3 days compared with ≤3 days (OR 2.62 vs. 1.48; p for subgroup difference = 0.03). Further subgroup analyses suggested that the association was consistent across subgroups stratified by study design, geographic region, mean age, sex distribution, diabetes proportion, follow-up duration, and study quality (all p for subgroup differences > 0.05).ConclusionHigher acute GV was associated with increased short-term mortality in patients with SAH. Prolonged glucose monitoring may enhance prognostic value. These findings suggest that acute glucose fluctuations may serve as a risk factor for short-term mortality in patients with SAH.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/search, identifier CRD420261330574.
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