Does diabetes influence outcomes after acute ischaemic stroke?

  • Akhtar N & al
  • J Stroke Cerebrovasc Dis
  • 10 Dec 2018

  • curated by Antara Ghosh
  • UK Clinical Digest
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Takeaway

  • In this single-centre study, patients with diabetes had a higher risk for in-hospital complications, greater disability at discharge and 90 days, and a higher incidence of recurrent stroke and mortality within 90 days of an acute ischaemic stroke.

Why this matters

  • Diabetes mellitus and hyperglycaemia are major risk factors for acute ischaemic stroke.

Study design

  • Prospective cohort study evaluated 2961 patients admitted with a diagnosis of acute ischaemic stroke between January 2014 and December 2017.
  • The modified Rankin scale (mRS) assessed at discharge and 90 days classified patients as having a good (mRS, ≤0-2) or poor (mRS, 3-6) outcome.
  • Funding: None.

Key results

  • Patients with diabetes vs prediabetes and nondiabetes had significantly higher prevalence of:
    • hypertension (80.8% vs 67.4 vs 59.2%; P<.0001>
    • previous stroke (18.0% vs 5.4% vs 6.2%; P<.0001 and>
    • coronary artery disease (12.9% vs 5.6% vs 5.0%; P<.0001 respectively.>
  • At admission, patients with diabetes vs prediabetes and nondiabetes had a higher incidence of:
    • all complications (7.6% vs 4.9% vs 4.5%; P=.004),
    • urinary tract infection (4.8% vs 2.8% vs 2.1%; P=.02) and
    • sepsis (1.6% vs 0% vs 0.8%; P=.013).
  • Percentage of patients with mRS 3-6 at discharge (39.7% vs 32.6% vs 30.2%; P<.0001 and days vs p was significantly greater in the diabetes prediabetes nondiabetes groups.>
  • At 90-days follow-up, mortality (6.2% vs 2.2% vs 5.2%; P=.033) and stroke recurrence (4.2% vs 0.7% vs 2.2%; P<.005 was significantly higher in diabetes vs prediabetes and no group.>

Limitations

  • Single-centre study.

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