Stress hyperglycemia is predictive of worse outcome in patients with acute ischemic stroke undergoing intravenous thrombolysis.
Aged
Blood Glucose
/ analysis
Female
Glycated Hemoglobin
/ analysis
Humans
Hyperglycemia
/ diagnosis
Intracranial Hemorrhages
/ diagnosis
Ischemic Stroke
/ blood
Italy
/ epidemiology
Male
Mortality
Outcome Assessment, Health Care
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
/ methods
Severity of Illness Index
Thrombolytic Therapy
/ adverse effects
Acute ischemic stroke
Intravenous thrombolysis
Outcome
Stress hyperglycemia
Journal
Journal of thrombosis and thrombolysis
ISSN: 1573-742X
Titre abrégé: J Thromb Thrombolysis
Pays: Netherlands
ID NLM: 9502018
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
pubmed:
25
8
2020
medline:
12
11
2021
entrez:
25
8
2020
Statut:
ppublish
Résumé
No study investigated the possible detrimental effect of stress hyperglycemia on patients affected acute ischemic stroke (AIS) undergoing intravenous thrombolysis (IVT). A new index, the glucose-to-glycated hemoglobin ratio (GAR), has been developed for assessing stress hyperglycemia. We retrospectively analyzed data from a prospectively collected database of consecutive patients admitted to the Udine University Hospital with AIS that were treated with IVT from January 2015 to December 2019. Four hundred and fourteen consecutive patients with AIS undergoing IVT entered the study. The patients were then stratified into four groups by quartiles of GAR (Q1-Q4). The higher GAR index was, the more severe stress hyperglycemia was considered. Prevalence of 3 months poor outcome (37.7% for Q1, 34% for Q2, 46.9% for Q3, and 66.7% for Q4, p for trend = 0.001), 3 months mortality (10.5% for Q1, 7.5% for Q2, 11.2% for Q3, and 27.1% for Q4, p for trend = 0.001), and symptomatic intracranial hemorrhage (0.9% for Q1, 0.9% for Q2, 5.1% for Q3, and 17.7% for Q4, p for trend = 0.001) was significant different among the four groups. AIS patients with severe stress hyperglycemia had a significantly increased risk of 3 months poor outcome (OR 2.43, 95% CI 1.14-5.22, p = 0.02), 3 months mortality (OR 2.38, 95% CI 1.01-5.60, p = 0.04), and symptomatic intracranial hemorrhage (OR 16.76, 95% CI 2.09-134.58, p = 0.008) after IVT. In conclusion, we demonstrated that stress hyperglycemia, as measured by the GAR index, is associated to worse outcome in AIS patients undergoing IVT.
Identifiants
pubmed: 32830310
doi: 10.1007/s11239-020-02252-y
pii: 10.1007/s11239-020-02252-y
doi:
Substances chimiques
Blood Glucose
0
Glycated Hemoglobin A
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
789-797Références
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