Jeremy Lew1, Vincent Thijs2, Leonid Churilov3, Geoffrey Donnan2, Warwick Park4, Raymond Robbins5, Graeme K Hart6, Christopher Bladin7, Kaylyn Khoo8, Lik-Hui Lau8, Alanna Tan8, Que Lam9, Douglas Johnson10, Jeffrey D Zajac1, Elif I Ekinci11. 1. Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia; Department of Medicine, Austin Health, The University of Melbourne, Australia. 2. Stroke Division, The Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia; Department of Neurology, Austin Health, Heidelberg, Vic., Australia. 3. Stroke Division, The Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia. 4. Department of Neurology, Austin Health, Heidelberg, Vic., Australia. 5. Department of Administrative Informatics, Austin Health, Heidelberg, Vic., Australia. 6. Department of Intensive Care, Austin Health, Heidelberg, Vic., Australia; Health and Biomedical Informatics Centre, University of Melbourne, Australia. 7. Stroke Division, The Florey Institute of Neuroscience and Mental Health, Melbourne, Vic., Australia; Department of Neurosciences, Eastern Health, Box Hill Hospital, Box Hill, Vic., Australia. 8. Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia. 9. Department of Pathology, Austin Health, Heidelberg, Vic., Australia. 10. Department of Medicine, Austin Health, The University of Melbourne, Australia; Department of General Medicine, Austin Health, Heidelberg, Vic., Australia. 11. Department of Endocrinology, Austin Health, Heidelberg, Vic., Australia; Department of Medicine, Austin Health, The University of Melbourne, Australia. Electronic address: elif.ekinci@unimelb.edu.au.
Abstract
AIMS: Diabetes is a major risk factor for stroke. We aimed to investigate the prevalence of diabetes and pre-diabetes within a stroke cohort and examine the association of glycaemia status with mortality and morbidity. METHODS: Inpatients aged ≥54 who presented with a diagnosis of stroke had a routine HbA1c measurement as part of the Austin Health Diabetes Discovery Initiative. Additional data were attained from hospital databases and Australian Stroke Clinical Registry. Outcomes included diabetes and pre-diabetes prevalence, length of stay, 6-month and in-hospital mortality, 28-day readmission rates, and 3-month modified Rankin scale score. RESULTS: Between July 2013 and December 2015, 610 patients were studied. Of these, 31% had diabetes while 40% had pre-diabetes. Using multivariable regression analyses, the presence of diabetes was associated with higher odds of 6-month mortality (OR = 1.90, p = 0.022) and higher expected length of stay (IRR = 1.29, p = 0.004). Similarly, a higher HbA1c was associated with higher odds of 6-month mortality (OR = 1.27, p = 0.005) and higher expected length of stay (IRR = 1.08, p = 0.010). CONCLUSIONS: 71% of this cohort had diabetes or pre-diabetes. Presence of diabetes and higher HbA1c were associated with higher 6-month mortality and length of stay. Further research is necessary to determine if improved glycaemic control may improve stroke outcomes.
AIMS: Diabetes is a major risk factor for stroke. We aimed to investigate the prevalence of diabetes and pre-diabetes within a stroke cohort and examine the association of glycaemia status with mortality and morbidity. METHODS: Inpatients aged ≥54 who presented with a diagnosis of stroke had a routine HbA1c measurement as part of the Austin Health Diabetes Discovery Initiative. Additional data were attained from hospital databases and Australian Stroke Clinical Registry. Outcomes included diabetes and pre-diabetes prevalence, length of stay, 6-month and in-hospital mortality, 28-day readmission rates, and 3-month modified Rankin scale score. RESULTS: Between July 2013 and December 2015, 610 patients were studied. Of these, 31% had diabetes while 40% had pre-diabetes. Using multivariable regression analyses, the presence of diabetes was associated with higher odds of 6-month mortality (OR = 1.90, p = 0.022) and higher expected length of stay (IRR = 1.29, p = 0.004). Similarly, a higher HbA1c was associated with higher odds of 6-month mortality (OR = 1.27, p = 0.005) and higher expected length of stay (IRR = 1.08, p = 0.010). CONCLUSIONS: 71% of this cohort had diabetes or pre-diabetes. Presence of diabetes and higher HbA1c were associated with higher 6-month mortality and length of stay. Further research is necessary to determine if improved glycaemic control may improve stroke outcomes.