Short term outcome of patients with hyperglycemia and acute stroke

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.