Yıl: 2021 Cilt: 20 Sayı: 2 Sayfa Aralığı: 79 - 85 Metin Dili: İngilizce DOI: 10.4274/eajem.galenos.2020.28247 İndeks Tarihi: 17-11-2021

The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke

Öz:
Aim: This study aimed to examine the relationship between short-term mortality and blood glucose values (BGV) obtained during the first week of ischemic stroke, when neurological causes, such as increased intracranial pressure, are mainly predominant in mortality prediction.Materials and Methods: This is a retrospective study that includes 417 patients with acute ischemic stroke (AIS), who were admitted to our hospital within the first 24 hours of the stroke. Data were recorded using the International Classification of Diseases Code. On the first, third, fifth, and seventh days of the stroke, the effect of BGV on the patient’s functional outcome was evaluated.Results: Of 417 patients, 90 (21.58%) died within a one-month follow-up period. There was no difference between the mortality and survival groups in terms of diabetes mellitus (DM) history (χ2=0.783; p=0.224). On the first, third, fifth, and seventh day of the stroke, BGV were significantly higher in the mortality group (130.5 mg/dL, 124.5 mg/dL, 133.5 mg/dL, and 132.5 mg/dL, respectively, according to the receiver operating characteristic analysis) than in the survival group (p<0.05). BGV of the fifth day (133.5 mg/dL) was an independent predictor for mortality (hazard ratio: 3.001; 95% confidence interval (1.43-6.3); p=0.004), while BGV of the other days were dependent on a coma scale.Conclusion: Hyperglycemia predicting short-term AIS mortality might be a DM-independent stress hyperglycemia. Although hyperglycemia is predominantly a coma-scale-dependent [modified Rankin Scale (mRS)] predictor during the first week of blood glucose monitoring, BGV of the fifth day may be an independent predictor of short-term mortality.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık
  • 1. Öztürk Ş. Epidemiology of cerebrovascular diseases and Risk factorsperspectives of the world and Turkey. Turk J Geriatr. 2009;13:51-8.
  • 2. Gaillard T, Miller E. Guidelines for Stroke Survivors With Diabetes Mellitus. Stroke. 2018;49:215-7.
  • 3. Zhang Z, Yan J, Shi H. Hyperglycemia as a Risk Factor of Ischemic Stroke. J Drug Metab Toxicol. 2013;4:153.
  • 4. Emerging Risk Factors Collaboration, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375:2215-22.
  • 5. Luitse MJ, Biessels GJ, Rutten GE, Kappelle LJ. Diabetes, hyperglycaemia, and acute ischaemic stroke. Lancet Neurol. 2012;11:261-71.
  • 6. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010 ;376:112-23.
  • 7. Tziomalos K, Spanou M, Bouziana SD, Papadopoulou M, Giampatzis V, Kostaki S, et al. Type 2 diabetes is associated with a worse functional outcome of ischemic stroke. World J Diabetes. 2014;5:939-44.
  • 8. Szczudlik A, Slowik A, Turaj W, Wyrwicz-Petkow U, Pera J, Dziedzic T, et al. Transient hyperglycemia in ischemic stroke patients. J Neurol Sci. 2001;189:105-11.
  • 9. Ntaios G, Egli M, Arsovska A, Joye D, Bettex Y, Lauber E, et al. An intravenous insulin protocol for strict glycemic control in acute ischaemic stroke. Eur J Neurol. 2012;19:443-51.
  • 10. Ntaios G, Faouzi M, Ferrari J, Lang W, Vemmos K, Michel P. An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score. Neurology. 2012;78:1916-22.
  • 11. O’Neill PA, Davies I, Fullerton KJ, Bennett D. Stress hormone and blood glucose response following acute stroke in the elderly. Stroke. 1991;22:842-7. 12. Rosso C, Attal Y, Deltour S, Hevia-Montiel N, Lehéricy S, Crozier S, et al. Hyperglycemia and the fate of apparent diffusion coefficient-defined ischemic penumbra. AJNR Am J Neuroradiol. 2011;32:852-6.
  • 13. Jørgensen H, Nakayama H, Raaschou HO, Olsen TS. Stroke in patients with diabetes. The Copenhagen Stroke Study. Stroke. 1994;25:1977-84.
  • 14. Karapanayiotides T, Piechowski-Jozwiak B, van Melle G, Bogousslavsky J, Devuyst G. Stroke patterns, etiology, and prognosis in patients with diabetes mellitus. Neurology. 2004;62:1558-62.
  • 15. Tuttolomondo A, Pinto A, Salemi G, Di Raimondo D, Di Sciacca R, Fernandez P, et al. Diabetic and non-diabetic subjects with ischemic stroke: differences, subtype distribution and outcome. Nutr Metab Cardiovasc Dis. 2008;18:152- 7.
  • 16. Stead LG, Gilmore RM, Bellolio MF, Mishra S, Bhagra A, Vaidyanathan L, et al. Hyperglycemia as an independent predictor of worse outcome in nondiabetic patients presenting with acute ischemic stroke. Neurocrit Care. 2009;10:181-6.
  • 17. Yong M, Kaste M. Dynamic of hyperglycemia as a predictor of stroke outcome in the ECASS-II trial. Stroke. 2008;39:2749-55.
  • 18. Capes SE, Hunt D, Malmberg K, Pathak P, Gerstein HC. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke. 2001;32:2426-32.
  • 19. Weir CJ, Murray GD, Dyker AG, Lees KR. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study. BMJ. 1997;314:1303-6.
  • 20. Kılıc S, Gultekin M, Soyuer F, Unluhizarci K, Soyuer A. The effect of temporary hyperglycemia on the prognosis of stroke in patients with acute ischemic stroke. Turk J Cereb Dis. 2012;8:72-6.
  • 21. Kreisel SH, Berschin UM, Hammes HP, Leweling H, Bertsch T, Hennerici MG, et al. Pragmatic management of hyperglycaemia in acute ischaemic stroke: safety and feasibility of intensive intravenous insulin treatment. Cerebrovasc Dis. 2009;27:167-75.
  • 22. Bruno A, Durkalski VL, Hall CE, Juneja R, Barsan WG, Janis S, et al. The Stroke Hyperglycemia Insulin Network Effort (SHINE) trial protocol: a randomized, blinded, efficacy trial of standard vs. intensive hyperglycemia management in acute stroke. Int J Stroke. 2014;9:246-51.
  • 23. Ntaios G, Papavasileiou V, Bargiota A, Makaritsis K, Michel P. Intravenous insulin treatment in acute stroke: a systematic review and meta-analysis of randomized controlled trials. Int J Stroke. 2014;9:489-93.
APA Tokgoz O, KARAKURT F, BUGRUL A (2021). The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. , 79 - 85. 10.4274/eajem.galenos.2020.28247
Chicago Tokgoz Osman Serhat,KARAKURT FERİDUN,BUGRUL Ahmet The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. (2021): 79 - 85. 10.4274/eajem.galenos.2020.28247
MLA Tokgoz Osman Serhat,KARAKURT FERİDUN,BUGRUL Ahmet The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. , 2021, ss.79 - 85. 10.4274/eajem.galenos.2020.28247
AMA Tokgoz O,KARAKURT F,BUGRUL A The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. . 2021; 79 - 85. 10.4274/eajem.galenos.2020.28247
Vancouver Tokgoz O,KARAKURT F,BUGRUL A The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. . 2021; 79 - 85. 10.4274/eajem.galenos.2020.28247
IEEE Tokgoz O,KARAKURT F,BUGRUL A "The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke." , ss.79 - 85, 2021. 10.4274/eajem.galenos.2020.28247
ISNAD Tokgoz, Osman Serhat vd. "The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke". (2021), 79-85. https://doi.org/10.4274/eajem.galenos.2020.28247
APA Tokgoz O, KARAKURT F, BUGRUL A (2021). The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. Eurasian Journal of Emergency Medicine, 20(2), 79 - 85. 10.4274/eajem.galenos.2020.28247
Chicago Tokgoz Osman Serhat,KARAKURT FERİDUN,BUGRUL Ahmet The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. Eurasian Journal of Emergency Medicine 20, no.2 (2021): 79 - 85. 10.4274/eajem.galenos.2020.28247
MLA Tokgoz Osman Serhat,KARAKURT FERİDUN,BUGRUL Ahmet The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. Eurasian Journal of Emergency Medicine, vol.20, no.2, 2021, ss.79 - 85. 10.4274/eajem.galenos.2020.28247
AMA Tokgoz O,KARAKURT F,BUGRUL A The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. Eurasian Journal of Emergency Medicine. 2021; 20(2): 79 - 85. 10.4274/eajem.galenos.2020.28247
Vancouver Tokgoz O,KARAKURT F,BUGRUL A The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke. Eurasian Journal of Emergency Medicine. 2021; 20(2): 79 - 85. 10.4274/eajem.galenos.2020.28247
IEEE Tokgoz O,KARAKURT F,BUGRUL A "The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke." Eurasian Journal of Emergency Medicine, 20, ss.79 - 85, 2021. 10.4274/eajem.galenos.2020.28247
ISNAD Tokgoz, Osman Serhat vd. "The Effect of Blood Glucose Value on the Short-term Mortality ofAcute Ischemic Stroke". Eurasian Journal of Emergency Medicine 20/2 (2021), 79-85. https://doi.org/10.4274/eajem.galenos.2020.28247