David B. Matchar, MD; George W. Divine, PhD; Albert Heyman, MD; John R. Feussner, MD
▪ Objective: 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.
▪ Design: Prospective, county-wide, multicenter cohort study.
▪ Setting: A community hospital, a university hospital, and a Veterans Affairs hospital.
▪ Patients: A cohort of 146 patients hospitalized with new atherothrombotic stroke.
▪ Measurements: 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.
▪ Results: 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.
▪ Conclusions: These data do not support an association between level of glycemia and outcome from acute stroke.
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Matchar DB, Divine GW, Heyman A, Feussner JR. The Influence of Hyperglycemia on Outcome of Cerebral Infarction. Ann Intern Med. 1992;117:449-456. doi: 10.7326/0003-4819-117-6-449
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Published: Ann Intern Med. 1992;117(6):449-456.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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