Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Stress hyperglycemia is associated with in-hospital mortality in patients with diabetes and acute ischemic stroke
First author：Donghua Mi
Corresponding author：Yongjun Wang
essential_information
- Person in charge：Donghua Mi
- Data Sources： CSCA
- Number of papers：CSCA20190963
- Published time：2022-01-27
2022-01-27
Published articles
Journal：CNS Neuroscience & Therapeutics
Publication type: Original Contributions
IF(IF): 7.035
PMID: 35084107 Link To Pubmed Full text Download
Background And Purpose
Stress hyperglycemia also occurs in diabetic patients with acute cerebrovascular disease. The effect of hyperglycemia on prognosis is not clear. In this study, we attempted to gauge how stress-induced hyperglycemia might worsen the outcomes of patients with diabetes following acute ischemic stroke.
Method
The glycemic gap levels and SHR were analyzed using the Meso Scale Discovery kit. The association of the levels of gap and SHR with in-hospital mortality were assessed using the Fisher exact and Kaplan–Meier log-rank tests.
Conclusion
The SHR may serve as an accessory parameter for the prognosis of patients with diabetes after acute ischemic stroke. Hyperglycemia in stroke patients with diabetes mellitus is associated with a higher risk of in-hospital death.
Main results
A total of 168,381 patients were included. The mean age was 66.2 ± 10.7, and 77,688 (43.0%) patients were female. The patients were divided into two groups: survivors (n = 167,499) and non‐survivors (n = 882), as well as into four groups according to their SHR quartiles (n = 42,090–42,099/quartile). There were 109 (0.26%), 142 (0.34%), 196 (0.47%), and 435 (1.03%) patients who died in the Q1, Q2, Q3, and Q4 quartiles, respectively. Compared with Q1 patients, the death risk was higher in Q4 patients (odds ratio (OR) = 4.02) (adjusted OR = 1.80, 95% confidence interval [CI] = 1.10–2.92, p = 0.018 after adjustment for traditional cardiovascular risk factors). The ROC analyses showed that SHR (AUC = 0.667, 95% CI: 0.647–0.686) had a better predictive value for mortality than that of fasting blood glucose (AUC = 0.633, 95% CI: 0.613–0.652) and HbA1c (AUC = 0.523, 95% CI: 0.504–0.543).