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

 -  2017 
<br/><br/> CONCLUSION: SFU 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 (c) 2017 Elsevier B.V. All rights reserved.  METHODS: We 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.  PURPOSE: Intracerebral 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 NC<sub>Ca-ATP</sub> 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.  RESULTS: 230 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 (4cm<sup>3</sup>, IQR: 1-12) compared to controls [ICH-score: 1 (IQR: 0-3); HV: 9cm<sup>3</sup> (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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0022-510X 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Cerebral Hemorrhage/co [Complications]<br/>*Cerebral Hemorrhage/dt [Drug Therapy]<br/>*Diabetes Complications/dt [Drug Therapy]<br/>*Sulfonylurea Compounds/ad [Administration & Dosage]<br/>Acute Disease<br/>Cerebral Hemorrhage/pa [Pathology]<br/>Diabetes Complications/pa [Pathology]<br/>Female<br/>Humans<br/>Linear Models<br/>Logistic Models<br/>Male<br/>Middle Aged<br/>Multivariate Analysis<br/>Pilot Projects<br/>Prospective Studies<br/>Retrospective Studies<br/>Severity of Illness Index<br/>Treatment Outcome
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>Critical Care Medicine
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article