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ABSTRACT: Background
Poststroke hyperglycemia is associated with poor outcomes. Most prior studies used initial glucose as an indicator of poststroke hyperglycemia without considering glycemic control status at the time of stroke occurrence. We aimed to investigate the effect of an admission-glucose gap on short-term functional outcomes in acute ischemic stroke (AIS).Methods
We enrolled patients with AIS or transient ischemic attack who had been admitted within 7 days of symptom onset to three stroke centers from May 2016 to December 2019. The admission-glucose gap between estimated average glucose levels (eAG) and initial glucose level (eAG-initial glucose) was categorized into four groups. The short-term functional outcome was evaluated using the modified Rankin Scale (mRS) score at 3 months after stroke onset and was dichotomized.Results
Among 1332 included subjects, 548 (41.1%) had poor short-term functional outcomes. After adjusting for multiple variables, a severe negative glucose gap (eAG-initial glucose ? -50 mg/dL) was significantly associated with poor short-term functional outcome (OR, 1.573; 95% CI, 1.101-2.248). After dichotomizing glycemic control status, its significance was only maintained in the good glycemic control group (HbA1c < 6.5%) (OR, 1.914; 95% CI, 1.155-3.169).Conclusions
An elevated admission-glucose gap, in which the initial glucose level was much higher than the estimated glucose level was based on HbA1c, was associated with poor stroke prognosis. In addition to admission-glucose levels, glycemic control status at the time of stroke onset should be considered when predicting short-term stroke outcomes.
SUBMITTER: Kim Y
PROVIDER: S-EPMC7922921 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Kim Yerim Y Lee Sang-Hwa SH Kim Chulho C Kang Min Kyoung MK Yoon Byung-Woo BW Kim Tae Jung TJ Bae Jong Seok JS Lee Ju-Hun JH
Journal of personalized medicine 20210218 2
<h4>Background</h4>Poststroke hyperglycemia is associated with poor outcomes. Most prior studies used initial glucose as an indicator of poststroke hyperglycemia without considering glycemic control status at the time of stroke occurrence. We aimed to investigate the effect of an admission-glucose gap on short-term functional outcomes in acute ischemic stroke (AIS).<h4>Methods</h4>We enrolled patients with AIS or transient ischemic attack who had been admitted within 7 days of symptom onset to t ...[more]