The influence of hyperglycemia on outcome of cerebral infarction

• Published in: Annals of internal medicine Vol. 117; no. 6; p. 449
• Main Authors: Matchar, D B, Divine, G W, Heyman, A, Feussner, J R
• Format: Journal Article
• Language: English
• Published: United States 15-09-1992
• Subjects: Acute Disease; Aged; Catecholamines - urine; Cerebral Infarction - complications; Cerebral Infarction - mortality; Cerebral Infarction - physiopathology; Disability Evaluation; Female; Glycated Hemoglobin A - analysis; Humans; Hydrocortisone - blood; Hyperglycemia - complications; Hyperglycemia - physiopathology; Male; Middle Aged; Prognosis; Prospective Studies; Regression Analysis; Survival Analysis
• ISSN: 0003-4819
• DOI: 10.7326/0003-4819-117-6-449

To determine whether hyperglycemia in the acute stroke period is associated with worse survival and functional outcome after accounting for acute stress response and chronic hyperglycemia.
Prospective, county-wide, multicenter cohort study.
A community hospital, a university hospital, and a Veterans Affairs hospital.
A cohort of 146 patients hospitalized with new atherothrombotic stroke.
Admission blood glucose concentration, demographic characteristics of patients, 24-hour urinary catecholamine, serum cortisol, and glycosylated hemoglobin levels; outcomes included mortality and functional outcome (Barthel index and Fugl-Meyer score) at 5, 30, 90, and 180 days after stroke.
Of the 996 patients with possible acute stroke who were screened, 146 (15%) were eligible for and consented to participate in the study; in most cases, exclusion from study was based on the absence of acute, atherothrombotic stroke. Overall, no evidence was found of a significant univariate association between admission blood glucose level and survival (relative risk, 1.02; 95% Cl, 0.94 to 1.09) or functional outcome (univariate regression coefficient for adjusted Fugl-Meyer score at day 30, - 0.36; Cl, - 1.08 to 0.27). This absence of an association persisted after adjustment for significant predictors of outcome in a multivariate model.
These data do not support an association between level of glycemia and outcome from acute stroke.