Short term outcome of patients with hyperglycemia and acute stroke

IF 0.3 Q4 CRITICAL CARE MEDICINE Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI:10.1016/j.ejccm.2017.11.003
Ahmed Al-Weshahy , Rania El-Sherif , Khaled Abd Al-Wahhab Selim , Ayman Heikal
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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.

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高血糖和急性脑卒中患者的短期预后
背景:先前存在的高血糖会恶化急性脑卒中的临床结果。非糖尿病患者的应激性高血糖与糖尿病(DM)患者有相似的结局吗?我们的目的是评估急性脑卒中后血糖状态及其对脑卒中预后的影响。方法对61例急性脑卒中患者进行分析。高血糖41例(糖尿病20例,非糖尿病21例),对照组20例。入院时进行血糖、CT脑及NIHSS检查。结果男性60.7%,平均年龄62.9 ± 10.5 岁。与对照组相比,高血糖患者的后循环影响发生率更高(19.5% vs. 0%, P = .03)。NIHSS高于对照组(14.9 ± 5.9 vs.7.8 ± 3.5,p = .000)。死亡率和住院时间均高于对照组(65.9% vs. 5.0%, P < )。0.001和12.5 ± 9.1 vs. 3.0 ± 4.2 天,P < 。001分别)。应激性高血糖组NIHSS评分和30 天死亡率高于糖尿病组(17 ± 5.1 vs. 12.7 ± 6.1,P = )。018, 85.7% vs. 45%, P = 。006分别)。30 天死亡率的预测因子为:高血压史(P = .04)、NIHSS ≥ 10(敏感性91%,特异性100%)和入院血糖 ≥ 223 mg/dL(敏感性63%,特异性96%)。结论高血糖与急性脑卒中后不良预后相关。HTN病史、入院血糖水平 ≥ 223 mg/dL和NIHSS ≥ 10是脑卒中预后较差的预测因素。
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来源期刊
自引率
0.00%
发文量
5
审稿时长
42 weeks
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.
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