Association Between Hyperglycemia and Short-Term Outcome in Patients with Ischemic Stroke

Abstract

Objective: We aimed to explore the differenceof short-term prognosis in controlled,
uncontrolled and non-diabetic patients suffering from ischemic stroke.
Methods: This was a prospective observational study conducted at Neurology department of
Services Hospital, Lahore over a period of 6 months from January 2014 to June 2014. A total of
113 patients with first-time ischemic stroke (confirmed on CT scan) were admitted in our
department. In all patients fasting blood glucose (FBG) level was monitored on 1st admission day
and history of Diabetes Mellitis (DM) was acquired. FBG >126mg/dl was taken as cut-off level. In
all patients with positive history of DM, HbA1C level was evaluated. So it divided our patients into
four groups: A) Uncontrolled Diabetics (HbA1C ≥6.5%, positive history of DM); B) Controlled
Diabetics (HbA1C 5.7-6.5%, positive history of DM); C) Impaired glucose group (Deranged FBG,
No history of DM); D) Normoglycemics (FBG <126mg/dl, No history of DM). The outcome in all
patients was measures in terms of early neurological deterioration (increase in the NIH Stroke
Scale (NIHSS) of ≥2 points during the first 14 days after admission) and poor short-term outcome
(30-day modified Ranking Scale [mRS] score 2-6) was evaluated.
Results: Of 113 patients, 17 patients were in group A (uncontrolled diabetics), 7 patients were in
group B (controlled diabetics), 4 patients were in group C (Impaires glucose group) and 85
patients (75.2%) were in group D (Normoglycemics). All the groups were comparable regarding
demographic details. The risk of early neurological deterioration was higher in group A (9/17
patients) (ORs=1.839; 95% CI, 0.707-4.782),) than group B (3/7 patients) (ORs=1.48; 95% CI,
0.35-6.31),), group C (1/4 patients) (ORs=0.868; 95% CI, 0.091-8.238), and group D (19/85
patients). Similarly the risk of poor short-term outcome was also significantly higher in the group A
(13/17 patients)( ORs=2.75; 95% CI, 0.83-8.238; p=0.047) than group B (5/7 patients)
(ORs=2.12; 95% CI, 0.389-11.54; p=0.207), group C (2/4 patients) (ORs=0.847; 95% CI, 0.114-
6.301; p=0.440), and group D (46/85 patients).
Conclusion: In our study population, patients having hyperglycemia with history of DM were
associated with poor short-term prognosis than those with normal glycemic readings after
ischemic stroke.