Impact of Stress-Induced Hyperglycemia on In-Hospital Medical Complications in Patients With Acute Stroke: From a Large-Scale Nationwide Longitudinal Registry.

Aims: This study aimed to explore the relationship between stress-induced hyperglycemia (SIH) and in-hospital medical complications in patients with acute stroke.

Methods: We enrolled 865,765 patients with acute stroke from the Chinese Stroke Center Alliance cohort. The stress hyperglycemia ratio (SHR) was defined as the ratio of fasting blood glucose to glycosylated hemoglobin. The primary outcomes were in-hospital medical complications, including urinary tract infection (UTI), pneumonia, deep venous thrombosis (DVT), pulmonary embolism (PE), gastrointestinal bleeding (GIB), and pressure sores. Logistic regression analyses were performed to assess the association between the SHR and in-hospital medical complications.

Results: In total, 104,873 (12.11%) patients with acute stroke experienced at least one in-hospital medical complication. The most frequently observed complications were pneumonia (9.84%), UTI (1.29%), and GIB (1.06%). Both univariate and multivariate logistic regression analyses showed that a higher SHR was associated with a higher prevalence of pneumonia, UTI, GIB, and pressure sores (P for trend < 0.01). After adjusting for potential confounders, a higher SHR was associated with a reduced risk of PE (P for trend < 0.05), whereas no significant association was found between SHR and DVT. In the subgroup analysis, a significant association between elevated SHR and the occurrence of in-hospital complications was further confirmed.

Conclusions: SIH is significantly associated with in-hospital medical complications, particularly pneumonia, UTI, GIB, and pressure sores, in patients with acute stroke.