Abstract:

Objective  To explore the relationship between fasting blood glucose level and prognosis for patients with acute stroke. Methods  699 consecutive patients with acute stroke were registered and included in the study. All patients underwent fasting blood glucose determination and quantification on the stroke severity based on National Institute of Health Stroke Scale (NIHSS) upon admission. A six-month prospective follow-up was performed in the eligible patients for the mortality and Modified Rankin Scale(MRS) was used to measure the degree of disability or dependence in the daily activities in the survivals. Multivariate logistic regression analysis was performed to determine the risk factors affecting prognosis of patients after stroke. Results The patients with history of diabetes had higher fasting blood glucose level, and accounted for a higher percentage in those with elevated level of fasting blood glucose. Although hyperglycemia was more frequent in patients with hemorrhagic stroke than those with ischemic stroke, yet the level was lower in patients with mild stroke than those with moderate stroke. Nevertheless, tendency of hyperglycemia remained no significant difference for those two groups of patients. The mortality at six-month was not significant between the patients with elevated blood glucose level and those with normal level, whereas patients with hyperglycemia were rated higher by the MRS. Multivariate logistic analysis showed that NIHSS>5 (OR=7.004, 95% CI: 4.490-10.925, P<0.001), attack history of cerebral infarction(OR=2.769, 95% CI: 1.237-6.197, P<0.05), age>70 years (OR= 2.549, 95% CI:1.633-3.980, P<0.001) and hyperglycemia (OR=1.808, 95% CI: 1.088-3.005, P<0.05) were independent prognostic factors for poor prognosis. Conclusion  Hyperglycemia was the independent prognostic factors for poor outcome in patients with acute stroke after six months of onset.

Key words:  Stroke, Hyperglycemia, Stroke register