• J. Neurol. Sci. · Oct 2017

    Sulfonylurea drug pretreatment and functional outcome in diabetic patients with acute intracerebral hemorrhage.

    • Jason J Chang, Yasser Khorchid, Ali Kerro, L Goodwin Burgess, Nitin Goyal, Anne W Alexandrov, Andrei V Alexandrov, and Georgios Tsivgoulis.
    • Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: jason.chang@medstar.net.
    • J. Neurol. Sci. 2017 Oct 15; 381: 182-187.

    PurposeIntracerebral hemorrhage (ICH) is associated with poor clinical outcome and high mortality. Sulfonylurea (SFU) use may be a viable therapy for inhibiting sulfonylurea receptor-1 and NCCa-ATP channels and reducing perihematomal edema and blood-brain barrier disruption. We sought to evaluate the effects of prehospital SFU use with outcomes in diabetic patients with acute ICH.MethodsWe retrospectively analyzed a cohort of diabetic patients presenting with acute ICH at a tertiary care center. Study inclusion criteria included spontaneous ICH etiology and age>18years. Baseline clinical severity was documented using ICH-score. Hematoma volumes (HV) on admission were calculated using ABC/2 formula. Unfavorable functional outcome was documented as discharge modified Rankin Scale scores 2-6.Results230 diabetic patients with acute ICH fulfilled inclusion criteria (mean age 64±13years, men 53%). SFU pretreatment was documented in 16% of the study population. Patients with SFU pretreatment had significantly (p<0.05) lower median ICH-scores (0, IQR: 0-2) and median admission HV (4cm3, IQR: 1-12) compared to controls [ICH-score: 1 (IQR: 0-3); HV: 9cm3 (IQR: 3-20)]. SFU pretreatment was independently (p=0.033) and negatively associated with the cubed root of admission HV (linear regression coefficient: -0.208; 95%CI: -0.398 to -0.017) in multiple linear regression analyses adjusting for potential confounders. Pretreatment with SFU was also independently (p=0.033) associated with lower likelihood of unfavorable functional outcome (OR=0.19; 95%CI: 0.04-0.88) in multivariable logistic regression models adjusting for potential confounders.ConclusionSFU pretreatment may be an independent predictor for improved functional outcome in diabetic patients with acute ICH. This association requires independent confirmation in a large prospective cohort study.Copyright © 2017 Elsevier B.V. All rights reserved.

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