• Dingding Zhang, Zong Zhuang, Yongxiang Wei, Xiangyu Liu, Wei Li, Yongyue Gao, Jinsong Li, and Chunhua Hang.
• Department of Neurosurgery, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, P.R. China.
• World Neurosurg. 2019 Jul 1; 127: e1145-e1151.

Background And PurposeSerum hyperglycemia and hypophosphatemia have been reported to be common in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to explore whether admission serum glucose-phosphate ratio was associated with the severity and prognosis of aSAH.MethodsWe retrospectively analyzed 198 patients with aSAH who were admitted within 24 hours of hemorrhage to a single academic hospital from June 2016 to September 2017. The following determinations were recorded: aSAH severity on admission, assessment by the World Federation of Neurosurgical Societies grading scale (WFNS), Fisher score defined according to the computed tomography results, and 3-month outcome assessed by the Glasgow Outcome Scale. A statistical analysis of the clinical and laboratory risk factors of poor outcome was conducted.ResultsAdmission serum glucose-phosphate ratio was increased in a WFNS grade-dependent manner and was higher in patients who had a poor outcome than in those who had a good outcome 3 months after aSAH. Multiple binomial logistic regression analysis showed that serum glucose-phosphate ratio, along with age, WFNS grade, and intraventricular hemorrhage, was associated with 3-month poor outcome after aSAH when we controlled for Fisher score, acute hydrocephalus, delayed cerebral ischemia, symptomatic cerebral vasospasm, serum glucose and phosphate levels, and glucose-potassium ratio. Receiver operating characteristic analysis showed that the area under the curve for glucose-phosphate ratio was significantly higher than age and intraventricular hemorrhage.ConclusionsThe study shows that the glucose-phosphate ratio is a potential biomarker that can reflect disease severity and prognosis in aSAH patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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