BACKGROUND, AIMS: Whether diabetes mellitus affects the prognosis of stroke patients, and whether admission hyperglycemia influences prognosis similarly in diabetic as in non-diabetic patients is assessed controversially. The aims of the study were: 1) to compare the course of diabetic and non-diabetic acute stroke patients, and 2) to assess the influence of admission serum glucose levels on case fatality. METHODS: In 57 Austrian medical departments the hospital course of consecutive stroke patients was documented prospectively between June 1999 and October 2000. RESULTS: Two hundred and ninety-six (30%) of 992 patients had a history of diabetes mellitus. Intracerebral hemorrhage was more frequent in non-diabetic patients than diabetic (13% versus 5%, P=0.0001). Coronary heart disease was more frequent in diabetic than in non-diabetic patients (35% versus 24%, P=0.0003). The case fatality was 18% among non-diabetic and 16% among diabetic patients (P=0.3559). Among patients who were discharged alive, the Barthel Index increased from 50 to 90 in non-diabetic and from 45 to 75 in diabetic patients (P=0.0403). In non-diabetic patients, admission serum glucose>9.2 mmol/L was associated with a more than 4-fold increase in case fatality, compared with patients with serum glucose<5.7 mmol/L (P<0.0001). CONCLUSIONS: Diabetic stroke patients need special care since they tend to have a poorer recovery than non-diabetic patients. Admission hyperglycemia in non-diabetic acute stroke patients predicts a poor prognosis.
BACKGROUND, AIMS: Whether diabetes mellitus affects the prognosis of strokepatients, and whether admission hyperglycemia influences prognosis similarly in diabetic as in non-diabeticpatients is assessed controversially. The aims of the study were: 1) to compare the course of diabetic and non-diabetic acute strokepatients, and 2) to assess the influence of admission serum glucose levels on case fatality. METHODS: In 57 Austrian medical departments the hospital course of consecutive strokepatients was documented prospectively between June 1999 and October 2000. RESULTS: Two hundred and ninety-six (30%) of 992 patients had a history of diabetes mellitus. Intracerebral hemorrhage was more frequent in non-diabeticpatients than diabetic (13% versus 5%, P=0.0001). Coronary heart disease was more frequent in diabetic than in non-diabeticpatients (35% versus 24%, P=0.0003). The case fatality was 18% among non-diabetic and 16% among diabeticpatients (P=0.3559). Among patients who were discharged alive, the Barthel Index increased from 50 to 90 in non-diabetic and from 45 to 75 in diabeticpatients (P=0.0403). In non-diabeticpatients, admission serum glucose>9.2 mmol/L was associated with a more than 4-fold increase in case fatality, compared with patients with serum glucose<5.7 mmol/L (P<0.0001). CONCLUSIONS:Diabetic strokepatients need special care since they tend to have a poorer recovery than non-diabeticpatients. Admission hyperglycemia in non-diabetic acute strokepatients predicts a poor prognosis.
Authors: Emmanuel I González-Moreno; Carlos R Cámara-Lemarroy; José G González-González; Fernando Góngora-Rivera Journal: Transl Stroke Res Date: 2014-08-03 Impact factor: 6.829