Hyperglycemia in nondiabetic patients during the acute phase of stroke

Godoy, Daniel Agustín; Soler, C. Rafael Trinchet; Videtta, Walter; Fuenzalida, L.C.; Paranhos, Jorge; Costilla, Marcelo; Piñero, Gustavo; Jibaja, Manuel; Melo, Leonardo Jardim Vaz de

doi:10.1590/s0004-282x2012000200012

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…In all patients, BG was documented and hyperglycemia was defined as BG level ≥ 140 mg/dl and normoglycemia as BG < 140 mg/dl [12]. DM was diagnosed if the patient had a pre-existing diagnosis of DM or was taking anti-diabetics drugs before stroke onset.…”

Section: Methodsmentioning

confidence: 99%

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia: a cross-sectional study

et al. 2019

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BackgroundAdmission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting.MethodsA prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 h of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as > 140 mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively.ResultsA total of 103 first-ever acute stroke patients were included (mean age = 55.5 + 15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10–19) compared to normoglycemic patients 11 (IQR 8–15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99–6.19) more likely to be functionally impaired (mRS = 3–5) at 30-days compared to normoglycemic patients (P = 0.041).Older age (≥ 65 years) (P = 0.017) and stroke severity (NIHSS > 14) (P = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association.ConclusionsHyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-day of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.

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Section: Methodsmentioning

confidence: 99%

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia: a cross-sectional study

et al. 2019

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“…NIHSS score was categorized into two: mild stroke (NIHSS score ≤ 14) and severe stroke (NIHSS score >14) [11]. In all patients, ABG was documented and hyperglycemia was defined as ABG level ≥140 mg/dl and normoglycemia as ABG <140mg/dl [12]. Known DM was diagnosed if patient was diagnosed with diabetes or taking antidiabetics drugs before stroke onset.…”

Section: Data Collectionmentioning

confidence: 99%

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia

Zewde

Mengesha

Feleke

et al. 2019

Preprint

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Background:- Although acute stroke accompanied by hyperglycemia is often associated with worse prognosis, the relationship between hyperglycemia and stroke outcome has not been studied in Ethiopian patients. As better understanding of this potentially adverse influence on stroke outcome would provide guidance for stroke management and acute care. This study aimed to determine frequency of admission hyperglycemia and its impact on thirty day functional outcome and case fatality among acute stroke patients in an urban setting in Ethiopia. Methods:- From July to December 2016, we collected information on 103 consecutive first ever acute stroke patients admitted within 72 hours of symptom onset to Tertiary hospital in Ethiopia. We obtained demographic, clinical and neuro-imaging data including capillary blood glucose at admission. National Institute of Health Stroke Scale and modified Rankin Scale were used to assess the baseline stroke severity and the degree of disability at thirty day. Results:- A total of 103 first ever acute stroke patients were enrolled with, mean age = 55.5+ 15.3 years, 64.1% male, 65% under the age of 65 years, and 31.1% were farmers by occupation . Fifty one (49.5%) patients had a documented hyperglycemia at admission with median National Institute of Health Stroke Scale score of 14 and 3(2.9%) of them were later diagnosed with diabetes mellitus. The mean modified Rankin score at 30-day was 3.6 + 1.45 while 34 (79.1%) of hyperglycemic stroke survivors scored between 3 and 5. Older age >65 years (p = 0.037), admission hyperglycemia (p = 0.04) and stroke severity (p <0.001) were significantly correlated with poor functional outcome. Conclusions:- High blood glucose on admission was significantly associated with sever disability in acute stroke patients, independent of the presence of diabetes mellitus. By establishing the negative impact of admission hyperglycemia on the neurological outcome, this study suggests that achieving normal blood glucose in the early stages of stroke could have a favorable impact on improved neurological outcome and quality of life for stroke patients. The study provides a rationale for acute stroke management that addresses the potentially adverse consequences of hyperglycemia at the time of presentation in an urban Ethiopian setting.

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“…The median NIHSS score was higher in the hyperglycemic (BG) patients (14)(15)(16)(17)(18)(19)) as compared to the normoglycemic patients (11)(12)(13)(14)(15)). But a multiple regression analysis showed there was no relationship between BG and stroke severity on admission NIHSS independent of age, sex, diagnosis of diabetes and stroke subtype (p = 0.42).…”

Section: Relationship Between Admission Blood Glucose Level and Clinimentioning

confidence: 98%

“…In all patients, BG was documented and hyperglycemia was defined as BG level ≥140 mg/dl and normoglycemia as BG <140mg/dl [12]. DM was diagnosed if the patient had a pre-existing diagnosis of DM or was taking anti-diabetics drugs before stroke onset.…”

Section: Baseline Data Collectionmentioning

confidence: 99%

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia: a cross-sectional study

Zewde

Mengesha

Feleke

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting.Methods: A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 hours of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as >140mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively.Results: A total of 103 first-ever acute stroke patients were included (mean age = 55.5+15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10-19) compared to normoglycemic patients 11 (IQR 8-15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99-6.19) more likely to be functionally impaired (mRS = 3-5) at 30-days compared to normoglycemic patients (p = 0.041).Older age (≥ 65 years) (p = 0.017) and stroke severity (NIHSS >14) (p = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among the patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association.Conclusions: Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-days of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.

show abstract

Hyperglycemia in nondiabetic patients during the acute phase of stroke

Cited by 5 publications

References 30 publications

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia: a cross-sectional study

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia: a cross-sectional study

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa teaching hospital, Addis Ababa, Ethiopia

The frequency and impact of admission hyperglycemia on short term outcome of acute stroke patients admitted to Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia: a cross-sectional study

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