Study of Hyperglycemia as a Prognostic Factor in Acute Ischemic Stroke

Abstract

Background: Acute ischemic stroke (AIS) is a grave threat to global healthcare system, which is accompanied by high disability and mortality. Stress hyperglycemia is common in critically ill patients and appears to be a marker of disease severity. Furthermore, both the admission as well as the mean glucose level during the hospital stay is strongly associated with patient outcomes. Objective: To determine the impact of hyperglycemia in AIS on short-term outcome and prognosis. Patients and methods: This was a cross-sectional study, which was carried out on 150 patients arrived to Emergency Department (ED) in Emergency Mansoura University Hospital with clinical presentation and radiological investigations of ischemic stroke over the period from June 2018 to May 2019. Results: There were statistically significant difference as regards both onset and course of symptoms among both groups. Normoglycemic group demonstrated significant increase as regards serum creatinine, while demonstrated significant decrease as regards SBP, DBP, Glasgow coma scale (GCS) and glucose level in comparison with hyperglycemic group. Normoglycemic group demonstrated better outcomes in terms of CT brain and CBC compared to hyperglycemic group. Hyperglycemic group demonstrated abnormal outcomes in terms of ABG. Hyperglycemic group demonstrated marked increase in overall mortality rate compared to normoglycemic one. There were significant increase in ward admission cases as regards onset GCS and significant decrease as regards stay duration more than one week in comparison with ICU admission cases. Conclusion: Stress hyperglycemia is common among acute stroke patients and was associated with less favorable outcomes especially in terms of mortality, hospital stay and functional outcome.