Ling Wang1, Zhiming Zhou2, Xiguang Tian3, Huaiming Wang4, Dong Yang5, Yonggang Hao6, Zhonghua Shi7, Min Lin8, Zhen Wang9, Dequan Zheng10, Mingyi Tu11, Wenjie Zi12, Gelin Xu13, Xinfeng Liu14. 1. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address: lingwang1101@163.com. 2. Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China. Electronic address: neuro_depar@hotmail.com. 3. Department of Neurology, Chinese Armed Police Force Guangdong Armed Police Corps Hospital, Guangzhou, Guangdong, China. Electronic address: wjgdtxg@126.com. 4. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address: wanghm89@163.com. 5. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address: yangdongchina@yeah.net. 6. Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China; Department of Emergency Medicine, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Electronic address: hyg3625@126.com. 7. Department of Neurosurgery, 101st Hospital of People's Liberation Army, Wuxi, Jiangsu, China. Electronic address: 18921150310@189.cn. 8. Department of Neurology, Fuzhou General Hospital of Nanjing Military Region, Fuzhou, Fujian, China. Electronic address: 35604214@qq.com. 9. Department of Neurology, Changsha Central Hospital, Changsha, Hunan, China. Electronic address: Docwz2007@163.com. 10. Department of Neurology, 175th Hospital of The People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou, Fujian, China. Electronic address: zdquang@sina.com.cn. 11. Department of Neurology, Hubei Wuchang Hospital, Wuhan, Hubei, China. Electronic address: 467128265@qq.com. 12. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address: ziwenjie1981@163.com. 13. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address: gelinxu@nju.edu.cn. 14. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address: xfliu2@vip.163.com.
Abstract
BACKGROUND AND PURPOSE: The impacts of stress hyperglycemia and hypoglycemia on mortality of acute ischemic stroke patients treated with mechanical thrombectomy (MT) are largely unclear. This study aimed to use stress hyperglycemia ratio (SHR) to evaluate the influence of pretreatment relative blood glucose changes on mortality risk after MT. METHODS: The study retrospectively enrolled 321 acute ischemic stroke patients treated with MT. SHR was calculated as random blood glucose at admission divided by average blood glucose which estimated by glycosylated hemoglobin (HbA1c). Patients with HbAlc greater than or equal to 6.5% were considered to have background hyperglycemia, patients were tertiled according to their SHR. Binary logistic regression was used to analyze 90 days mortality between SHR categories. RESULTS: Compared with the middle tertiles group (Q2) which the blood glucose is closet to baseline glycaemia, patients in the lowest tertiles group (Q1) and highest tertiles group (Q3) have a higher mortality risk (odds ratio [OR], 3.80; 95% confidence interval [CI], 1.31-11.06) (OR, 3.18; 95% CI, 1.25-8.12), the differences is still significant after further adjusted for admission hyperglycemia (≥11.1 mmol/L). In patients without background hyperglycemia, the mortality risk is significantly higher in Q3 group (OR, 3.01; 95% CI, 1.06-8.53), no significant differences was found between three groups after adjusted for admission hyperglycemia (≥11.1 mmol/L). CONCLUSIONS: SHR identified acute ischemic stroke patients with relative hyperglycemia and hypoglycemia may have higher mortality risk after MT.
BACKGROUND AND PURPOSE: The impacts of stress hyperglycemia and hypoglycemia on mortality of acute ischemic strokepatients treated with mechanical thrombectomy (MT) are largely unclear. This study aimed to use stress hyperglycemia ratio (SHR) to evaluate the influence of pretreatment relative blood glucose changes on mortality risk after MT. METHODS: The study retrospectively enrolled 321 acute ischemic strokepatients treated with MT. SHR was calculated as random blood glucose at admission divided by average blood glucose which estimated by glycosylated hemoglobin (HbA1c). Patients with HbAlc greater than or equal to 6.5% were considered to have background hyperglycemia, patients were tertiled according to their SHR. Binary logistic regression was used to analyze 90 days mortality between SHR categories. RESULTS: Compared with the middle tertiles group (Q2) which the blood glucose is closet to baseline glycaemia, patients in the lowest tertiles group (Q1) and highest tertiles group (Q3) have a higher mortality risk (odds ratio [OR], 3.80; 95% confidence interval [CI], 1.31-11.06) (OR, 3.18; 95% CI, 1.25-8.12), the differences is still significant after further adjusted for admission hyperglycemia (≥11.1 mmol/L). In patients without background hyperglycemia, the mortality risk is significantly higher in Q3 group (OR, 3.01; 95% CI, 1.06-8.53), no significant differences was found between three groups after adjusted for admission hyperglycemia (≥11.1 mmol/L). CONCLUSIONS: SHR identified acute ischemic strokepatients with relative hyperglycemia and hypoglycemia may have higher mortality risk after MT.
Authors: Kotryna Genceviciute; Martina B Göldlin; Christoph C Kurmann; Adnan Mujanovic; Thomas R Meinel; Johannes Kaesmacher; David J Seiffge; Simon Jung; Pasquale Mordasini; Urs Fischer; Jan Gralla; Hakan Sarikaya; Barbara Goeggel Simonetti; Kateryna Antonenko; Roza M Umarova; Lia Bally; Marcel Arnold; Mirjam R Heldner Journal: Eur J Neurol Date: 2022-07-01 Impact factor: 6.288
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