Stress hyperglycemia as a prognostic factor in acute ischemic stroke patients: a prospective observational cohort study

El-Gendy, Hanaa A.; Mohamed, Mahmoud A.; Abd-Elhamid, Amr E.; Nosseir, Mohammed A.

doi:10.1186/s42077-020-00122-6

Stress hyperglycemia as a prognostic factor in acute ischemic stroke patients: a prospective observational cohort study

Authors

10.1186/s42077-020-00122-6

Abstract

Background
Hyperglycemia is a risk factor for infarct expansion and poor outcome for both diabetic and non-diabetic patients. We aimed to study the prognostic value of stress hyperglycemia on the outcome of acute ischemic stroke patients as regards National Institutes of Health Stroke Scale (NIHSS) as a primary outcome.
Results
Patients with high random blood sugar (RBS) on admission showed significantly higher values of both median NIHSS score and median duration of hospital stay. There were significant associations between stress hyperglycemia and the risk of 30-day mortality ( < 0.001), the need for mechanical ventilation ( < 0.001) and vasopressors ( < 0.001), and the occurrence of hemorrhagic transformation ( = 0.001). The 24-h RBS levels at a cut off > 145 mg/dl showed a significantly good discrimination power for 30-day mortality (area under the curve = 0.809).
Conclusions
Stress hyperglycemia had a prognostic value and was associated with less-favorable outcomes of acute stroke patients. Therefore, early glycemic control is recommended for those patients.

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