Evidence map›Paper›PMID 31111113›Full record

ArticleHeliyon2019

A paradoxical relationship between hemoglobin A1C and in-hospital mortality in intracerebral hemorrhage patients.

Sudeepta Dandapat, Fazeel M Siddiqui, Gregg C Fonarow, Deepak L Bhatt, Haolin Xu, Roland Matsouaka, Paul A Heidenreich, Ying Xian, Lee H Schwamm, Eric E Smith

Open access · goldAbstract read
In one paragraph

Article in Heliyon, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 2 countries.

Sudeepta DandapatUniversity of Iowa, USA.
Fazeel M SiddiquiSouthern Illinois University, USA.
Gregg C FonarowDivision of Cardiology, University of California Los Angeles, USA.
Deepak L BhattBrigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, USA.
Haolin XuDuke University, USA.
Roland MatsouakaDuke University, USA.
Paul A HeidenreichStanford University School of Medicine, USA.
Ying XianDuke University, USA.
Lee H SchwammMassachusetts General Hospital and Harvard Medical School, USA.
Eric E SmithHotchkiss Brain Institute, University of Calgary, Canada.
Duke University · USBrigham and Women's Hospital · USHarvard University · USStanford University · USUniversity of Calgary · CAUniversity of California, Los Angeles · USUniversity of Iowa · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe relationship between prior glycemic status and outcomes in intracerebral hemorrhage (ICH) is not established. We hypothesized that higher hemoglobin (Hb) A1c is associated with worse outcomes in ICH. PATIENTS AND

methodsUsing the GWTG-Stroke registry, data on patients with ICH between April 1, 2003 and September 30, 2015 were harvested. Patients were divided into four ordinal groups based on HbA1c values of <5.7%, 5.7-6.4%, 6.5-8.0% and >8.0%. Outcomes (mortality, modified Rankin Scale (mRS), home discharge and independent ambulatory status) were analyzed for patients overall and separately for patients with or without history of diabetes using multivariable regression models.

resultsAmong 75,455 patients with ICH (with available HbA1c data), patients with lower HbA1c (<5.7%) had higher rates of in-hospital mortality in the entire cohort (15.5%; 3947/25473); as well as those with history of diabetes (19.0%; 542/2852). Among those without history of diabetes, both lower HbA1c (15.1%; 3405/22621) and higher HbA1c (>8.0%), (15.0%; 205/1364) were associated with higher in-hospital mortality. Lower HbA1c was also associated with higher mRS, less chance of going home, and lower likelihood of having independent ambulatory status in patients with prior history of diabetes.

conclusionsAmong patients with no reported history of diabetes, both very low and very high HbA1c were directly associated with higher in-hospital mortality. Only very low HbA1c was associated with higher mortality in known diabetic patients. Further studies are needed to better define the relationship between HbA1c and outcomes, for it may have important implications for care of ICH patients.

Indexed as

Neurology

Identifiers

PMID31111113
PMCPMC6512558
OpenAlexW2944604917

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.