Association of Acute Stroke and Glycemic Abnormalities with Stroke Outcome: A Hospital Based Study.

Abstract

Stroke is a major health burden and a leading cause of morbidity and mortality. Acute stroke is stressful event and patients suffering from an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a preexisting diabetes mellitus. This cross sectional observational study was conducted in the Department of Medicine and Neuromedicine, Mymensingh Medical College Hospital, Bangladesh from 16th August 2020 to 15th February 2021 to evaluate the glycaemic status in first ever ischaemic stroke patient admitted within 24 hours in a tertiary care hospital. Data were collected from the patients or informant and recorded in structured case record form. Thorough clinical examination and relevant investigation were done. SPSS and Microsoft excel were used for data analysis and processing. On assessment of glycaemic status, 71.0% of patients were found to have blood sugar level ≤7.7 mmol/L where 29.0% patients were blood sugar level ≥7.8mmol/L. This study demonstrated that, prevalence of acute stress hyperglycemia in stroke patient is detected 29.0% in tertiary centre hospital of Bangladesh. Evaluation was done on the basis of patient's symptoms, degree of disability or dependence in the daily activities and clinical outcome and it was measured by modified Rankin Scale (MRS). Study shows that 81.0% of the patients recovered (MRS score 0 to 2), among them maximum were normo-glycemics patients (90.1% vs. 51.7%). Fourteen patients developed poor outcome, they were disabled and discharged on request or risk bond (MRS score 3 to 5). In this study 7.0% expired during hospital stay (MRS score 6). In expired case maximum were stress hyper-glycemics patients (2.8% vs. 17.2%). So, in-hospital outcome is very poor in stress hyper-glycemics patients. We investigated association between acute stroke and glycaemic abnormalities, and found that stroke or other vascular event is harbor, or risk factor for prediabetes and diabetes. Proper evaluation, prevention of risk factor, and strict glycemic control is suggested for prevention of complication and reduction of occurrence of such event.