The factors associated with a functional outcome after ischemic stroke in diabetic patients: The Fukuoka Stroke Registry

Abstract

Background The prognosis in ischemic stroke is poor in diabetic patients. However, scant research has so far been done on the predisposing factors associated with poor outcomes. Methods We prospectively investigated the background characteristics and prognosis at 3 months in 241 consecutive diabetic patients having their first ischemic stroke (153 males, 88 females, mean age ± SD, 71 ± 10 years). Poor functional outcome was defined as modified Rankin scale ≥ 3 at 3 months after onset. Results Univariate analysis showed that age, dementia, initial National Institutes of Health Stroke Scale (NIHSS) score, systolic blood pressure on admission, proteinuria, stroke subtype, and prior use of angiotensin receptor blocker (ARB) were significantly related to an outcome at 3 months after onset. A multivariate logistic regression analysis showed that age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01 to 1.13, p = 0.017, per 1-year increase), NIHSS score (OR 1.22, 95% CI 1.12 to 1.35, p < 0.001, per 1-score increase), and proteinuria (OR 4.22, 95% CI 1.71 to 10.92, p = 0.002) were significantly and independently associated with poor clinical outcome after ischemic stroke in diabetic patients. Conversely, prior use of ARB (OR 0.28, 95% CI 0.09 to 0.79, p = 0.023) was associated with a better outcome. Conclusions In diabetic patients, proteinuria was independently associated with a poor clinical outcome after ischemic stroke, whereas the prior use of ARB appeared to be beneficial.