THE PROGNOSTIC VALUE OF THE GLYCEMIC GAP FOR EARLY NEUROLOGICAL DETERIORATION IN ACUTE HEMORRHAGIC STROKE PATIENTS
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Abstract
Objectives: To determine the prognostic value of the glycemic gap (GG) for early neurological deterioration (END) in patients with acute hemorrhagic stroke. Methods: A cross-sectional descriptive study on 302 patients with acute hemorrhagic stroke admitted to Military Hospital 103 from December 2024 to October 2025. END was defined as an increase of ≥ 4 in NIHSS and/or a decrease of ≥ 2 in Glasgow Coma Scale within 48 hours of admission. GG was calculated as the admission serum glucose minus the estimated average glucose. Statistical analyses included logistic regression and ROC curve analysis. Results: The incidence of END was 40.4%. The median GG was significantly higher in the END group compared to the non-END group (1.8 vs. -0.3; p < 0.001). The optimal cut-off value of GG for predicting END was 1.4 (AUC = 0.73; sensitivity of 55.7%; specificity of 82.8%). Multivariate logistic regression analysis showed that patients with GG ≥ 1.4 had a 2.9-fold higher risk of END (95%CI: 1.5 - 5.8; p = 0.002). Conclusion: Admission GG has been preliminarily shown to be a relevant factor with prognostic value for END in patients with acute hemorrhagic stroke and may aid in risk stratification for END in clinical practice.
Keywords
Acute hemorrhagic stroke, Early neurological deterioration, Glycemic gap
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References
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