BACKGROUND: Elevated blood glucose levels following acute ischemic stroke have been associated with adverse clinical outcomes in thrombolytic and nonthrombolytic treated patients. The current study examined multiple blood glucose parameters and their association with modified Rankin Scale (mRS) score at 3 months following mechanical thrombectomy and hospital discharge. METHODS: Acute ischemic stroke patients undergoing mechanical thrombectomy with a retrievable stent at two stroke centers were studied. Admission blood glucose level, maximum blood glucose during the hospital stay, and serial blood glucose measurements within the first 24 h of hospital admission were recorded. Variability in blood glucose level was represented by the standard deviation of the serial measurements within the first 24 h. The following demographic and clinical data was also collected: age, sex, baseline NIHSS score, onset-to-reperfusion times, hemoglobin A1c, and stroke mechanism. RESULTS: 79 patients were identified; at 3 months, 35 patients had an mRS score of 0-2 and 44 had had an mRS of 3-6. Among the blood glucose variables, standard deviation of blood glucose in the first 24 h following admission and maximum blood glucose during hospital stay were significantly higher in the mRS 3-6 group. In multivariate logistic regression analysis, only the standard deviation of blood glucose remained significant (OR = 1.07, 95% CI = 1.02-1.11, p = 0.003) in a model that adjusted for admission NIHSS score (p = 0.016) and number of stent retriever passes (p = 0.042). CONCLUSIONS: Greater blood glucose variability following acute ischemic stroke is associated with worse clinical outcome in patients undergoing mechanical thrombectomy.
BACKGROUND: Elevated blood glucose levels following acute ischemic stroke have been associated with adverse clinical outcomes in thrombolytic and nonthrombolytic treated patients. The current study examined multiple blood glucose parameters and their association with modified Rankin Scale (mRS) score at 3 months following mechanical thrombectomy and hospital discharge. METHODS: Acute ischemic stroke patients undergoing mechanical thrombectomy with a retrievable stent at two stroke centers were studied. Admission blood glucose level, maximum blood glucose during the hospital stay, and serial blood glucose measurements within the first 24 h of hospital admission were recorded. Variability in blood glucose level was represented by the standard deviation of the serial measurements within the first 24 h. The following demographic and clinical data was also collected: age, sex, baseline NIHSS score, onset-to-reperfusion times, hemoglobin A1c, and stroke mechanism. RESULTS: 79 patients were identified; at 3 months, 35 patients had an mRS score of 0-2 and 44 had had an mRS of 3-6. Among the blood glucose variables, standard deviation of blood glucose in the first 24 h following admission and maximum blood glucose during hospital stay were significantly higher in the mRS 3-6 group. In multivariate logistic regression analysis, only the standard deviation of blood glucose remained significant (OR = 1.07, 95% CI = 1.02-1.11, p = 0.003) in a model that adjusted for admission NIHSS score (p = 0.016) and number of stent retriever passes (p = 0.042). CONCLUSIONS: Greater blood glucose variability following acute ischemic stroke is associated with worse clinical outcome in patients undergoing mechanical thrombectomy.
Authors: José Alvarez-Sabín; Carlos A Molina; Joan Montaner; Juan F Arenillas; Rafael Huertas; Marc Ribo; Agusti Codina; Manuel Quintana Journal: Stroke Date: 2003-04-03 Impact factor: 7.914
Authors: Marc Ribo; Carlos Molina; Joan Montaner; Marta Rubiera; Raquel Delgado-Mederos; Juan F Arenillas; Manuel Quintana; José Alvarez-Sabín Journal: Stroke Date: 2005-07-07 Impact factor: 7.914
Authors: Sabareesh K Natarajan; Paresh Dandona; Yuval Karmon; Albert J Yoo; Junaid S Kalia; Qing Hao; Daniel P Hsu; L Nelson Hopkins; David J Fiorella; Bernard R Bendok; Thanh N Nguyen; Marilyn M Rymer; Ashish Nanda; David S Liebeskind; Osama O Zaidat; Raul G Nogueira; Adnan H Siddiqui; Elad I Levy Journal: J Neurosurg Date: 2011-02-25 Impact factor: 5.115
Authors: Niaz Ahmed; Antoni Dávalos; Niclas Eriksson; Gary A Ford; Joerg Glahn; Michael Hennerici; Robert Mikulik; Markku Kaste; Kennedy R Lees; Perttu J Lindsberg; Danilo Toni Journal: Arch Neurol Date: 2010-09
Authors: Mayank Goyal; Bijoy K Menon; Wim H van Zwam; Diederik W J Dippel; Peter J Mitchell; Andrew M Demchuk; Antoni Dávalos; Charles B L M Majoie; Aad van der Lugt; Maria A de Miquel; Geoffrey A Donnan; Yvo B W E M Roos; Alain Bonafe; Reza Jahan; Hans-Christoph Diener; Lucie A van den Berg; Elad I Levy; Olvert A Berkhemer; Vitor M Pereira; Jeremy Rempel; Mònica Millán; Stephen M Davis; Daniel Roy; John Thornton; Luis San Román; Marc Ribó; Debbie Beumer; Bruce Stouch; Scott Brown; Bruce C V Campbell; Robert J van Oostenbrugge; Jeffrey L Saver; Michael D Hill; Tudor G Jovin Journal: Lancet Date: 2016-02-18 Impact factor: 79.321
Authors: Michel T Torbey; Qi Pauls; Nina Gentile; Mercedes Falciglia; William Meurer; Creed L Pettigrew; Valerie L Durkalski; Thomas Bleck; Askiel Bruno Journal: Stroke Date: 2022-03-25 Impact factor: 7.914