Ahmed Al-Weshahy , Rania El-Sherif , Khaled Abd Al-Wahhab Selim , Ayman Heikal
{"title":"Short term outcome of patients with hyperglycemia and acute stroke","authors":"Ahmed Al-Weshahy , Rania El-Sherif , Khaled Abd Al-Wahhab Selim , Ayman Heikal","doi":"10.1016/j.ejccm.2017.11.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Preexisting hyperglycemia worsens the clinical outcome of acute stroke. Do non-diabetic patients with stress hyperglycemia have a similar outcome to those with diabetes mellitus (DM)?</p><p>We aimed to assess the glycemic status after acute stroke and its role on stroke outcome.</p></div><div><h3>Methods</h3><p>61 consecutive patients with acute stroke were included. 41 had hyperglycemia (20 diabetics and 21 non diabetics) and 20 were control. Admission blood glucose level, CT brain and NIHSS were performed. 30 days mortality was the study endpoint.</p></div><div><h3>Results</h3><p>60.7% males with mean age of 62.9 ± 10.5 years. Compared to control, patients with hyperglycemia had a higher incidence of posterior circulation affection (19.5% vs. 0%, P = .03). The NIHSS was statistically higher than control (14.9 ± 5.9 vs.7.8 ± 3.5, p = .000). The mortality rate and the hospital length of stay were higher than control (65.9% vs. 5.0%, P < .001 and 12.5 ± 9.1 vs. 3.0 ± 4.2 days, P < .001 respectively). NIHSS score, and 30 days mortality were higher in stress hyperglycemia compared to diabetics (17 ± 5.1 vs. 12.7 ± 6.1, P = .018, and 85.7% vs. 45%, P = .006 respectively). Predictors of 30 days mortality were: history of hypertension (P = .04), NIHSS ≥ 10 (sensitivity 91% and specificity 100%) and admission blood glucose ≥ 223 mg/dL (sensitivity 63% and specificity 96%).</p></div><div><h3>Conclusions</h3><p>Hyperglycemia is associated with poor outcomes after acute stroke. History of HTN, admission glucose level ≥ 223 mg/dL and NIHSS ≥ 10 were predictors of worse stroke outcome.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 93-98"},"PeriodicalIF":0.3000,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.11.003","citationCount":"10","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2090730317300397","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 10
Abstract
Background
Preexisting hyperglycemia worsens the clinical outcome of acute stroke. Do non-diabetic patients with stress hyperglycemia have a similar outcome to those with diabetes mellitus (DM)?
We aimed to assess the glycemic status after acute stroke and its role on stroke outcome.
Methods
61 consecutive patients with acute stroke were included. 41 had hyperglycemia (20 diabetics and 21 non diabetics) and 20 were control. Admission blood glucose level, CT brain and NIHSS were performed. 30 days mortality was the study endpoint.
Results
60.7% males with mean age of 62.9 ± 10.5 years. Compared to control, patients with hyperglycemia had a higher incidence of posterior circulation affection (19.5% vs. 0%, P = .03). The NIHSS was statistically higher than control (14.9 ± 5.9 vs.7.8 ± 3.5, p = .000). The mortality rate and the hospital length of stay were higher than control (65.9% vs. 5.0%, P < .001 and 12.5 ± 9.1 vs. 3.0 ± 4.2 days, P < .001 respectively). NIHSS score, and 30 days mortality were higher in stress hyperglycemia compared to diabetics (17 ± 5.1 vs. 12.7 ± 6.1, P = .018, and 85.7% vs. 45%, P = .006 respectively). Predictors of 30 days mortality were: history of hypertension (P = .04), NIHSS ≥ 10 (sensitivity 91% and specificity 100%) and admission blood glucose ≥ 223 mg/dL (sensitivity 63% and specificity 96%).
Conclusions
Hyperglycemia is associated with poor outcomes after acute stroke. History of HTN, admission glucose level ≥ 223 mg/dL and NIHSS ≥ 10 were predictors of worse stroke outcome.
期刊介绍:
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.