国家神经系统疾病临床医学研究中心数据管理与共享系统
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
第一作者：Donghua Mi
通讯作者：Yongjun Wang
基本信息
- 负责人：Donghua Mi
- 数据来源： CSCA
- 论文编号：CSCA20190963
- 发表时间：2022-01-27
2022-01-27
已发表文章
发表杂志：CNS Neuroscience & Therapeutics
发表类型: Original Contributions
影响因子(IF): 7.035
PMID: 35084107 Pubmed原文链接 全文下载
主要研究背景及目的
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.
方法
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.
结论
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.
主要结果
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).