{
  "abstract": "Introduction Admission hyperglycemia is common in large vessel occlusion stroke (LVOS) and has been associated with increased risk of intracranial hemorrhage (ICH) and poor outcomes. Stress hyperglycemia ratio (SHR), a marker of relative hyperglycaemia increases risk of ICH. However, its predictive value for parenchymal hematoma (PH), which is closely tied to reperfusion injury and clinical deterioration, remains nascent.Methods In this retrospective cohort study, we included 299 consecutive adult patients with anterior circulation LVOS who received bridging intravenous thrombolysis within 4.5 hours of last-known-well-with or without subsequent endovascular therapy-at two U.S. comprehensive stroke centers. SHR was defined as admission blood glucose (BG) divided by estimated average glucose derived from HbA1c. Post-treatment hemorrhages were classified using the Heidelberg Bleeding Classification. Multivariable logistic regression identified predictors of PH and receiver operating characteristic (ROC) analysis quantified discriminative performance (AUC).Results PH occurred in 12.4% and overall ICH in 44.6% of patients. SHR was significantly higher in patients with PH (p=0.001). SHR independently predicted PH both as a continuous variable (adjusted OR 4.60, 95%CI: 1.29-16.40) and when dichotomized at the cohort median of 1.03 (aOR 5.60, 95% CI: 2.18-14.40). BG and HbA1c were not associated with PH (both p>0.2). SHR and admission hyperglycaemia were not associated with overall ICH (both p>0.06). ROC analysis showed moderate discrimination for SHR ≥ median AUC: 0.65 (95% CI: 0.57-0.72).Conclusions SHR was independently associated with PH after bridging thrombolysis, whereas absolute admission hyperglycemia was not. SHR may represent a more mechanistically relevant biomarker for reperfusion-related hemorrhagic transformation in LVOS. Prospective validation is warranted.Disclosures A. Krishnakumar: None. K. Darko: None. G. Badger: None. V. Bohl: None. C. Schirmer: None.",
  "authors": [
    {
      "affiliations": [
        "Geisinger Medical Center, Danville, PA"
      ],
      "name": "A Krishnakumar"
    },
    {
      "affiliations": [
        "Geisinger Medical Center, Danville, PA"
      ],
      "name": "K Darko"
    },
    {
      "affiliations": [
        "School of Medicine, Geisinger College of Health Sciences, Scranton, PA"
      ],
      "name": "KE Kline"
    },
    {
      "affiliations": [
        "Geisinger Commonwealth School of Medicine, Scranton, PA"
      ],
      "name": "TM Bielinski"
    },
    {
      "affiliations": [
        "Geisinger Commonwealth School of Medicine, Scranton, PA"
      ],
      "name": "G Badger"
    },
    {
      "affiliations": [
        "Geisinger Commonwealth School of Medicine, Scranton, PA"
      ],
      "name": "V Bohl"
    },
    {
      "affiliations": [
        "Neurosurgery, Geisinger Health, Danville, PA"
      ],
      "name": "O Goren"
    },
    {
      "affiliations": [
        "Geisinger Medical Center, Danville, PA"
      ],
      "name": "C Schirmer"
    },
    {
      "affiliations": [
        "Geisinger, Danville, PA"
      ],
      "name": "P Hendrix"
    }
  ],
  "title": "P-016 Stress hyperglycemia ratio and parenchymal hematoma after bridging thrombolysis in large vessel occlusion stroke thrombectomy",
  "uid": "fc6d177c-3bf9-5ecc-822f-e4ef26b19922"
}