Acute glycemic variability and short-term mortality of patients with subarachnoid hemorrhage: a meta-analysis

Acute glycemic variability (GV) has been proposed as a potential prognostic marker in critically ill patients, but its association with mortality in subarachnoid hemorrhage (SAH) remains unclear. We conducted a meta-analysis to evaluate the relationship between acute GV and short-term mortality in patients with SAH.

PubMed, Embase, Web of Science, Wanfang, and CNKI were searched from inception to identify longitudinal observational studies assessing acute GV during hospitalization and reporting short-term mortality (≤90 days) in adult patients with SAH. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random-effects models accounting for the influence of potential heterogeneity.

Seven cohort studies involving 10,119 patients were included, among whom 2,485 (24.6%) died within 90 days. Pooled results suggested that high acute GV was significantly associated with increased short-term mortality (OR 1.64, 95% CI 1.34-2.01; p < 0.001; I ² = 15%). Subgroup analyses showed a stronger association was observed in studies with glucose monitoring > 3 days compared with ≤3 days (OR 2.62 vs. 1.48; p for subgroup difference = 0.03). Further subgroup analyses suggested that the association was consistent across subgroups stratified by study design, geographic region, mean age, sex distribution, diabetes proportion, follow-up duration, and study quality (all p for subgroup differences > 0.05).

Higher acute GV was associated with increased short-term mortality in patients with SAH. Prolonged glucose monitoring may enhance prognostic value. These findings suggest that acute glucose fluctuations may serve as a risk factor for short-term mortality in patients with SAH.

https://www.crd.york.ac.uk/prospero/search, identifier CRD420261330574.