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Relationship of initial glucose level and all-cause death in patients with ischaemic stroke: the roles of diabetes mellitus and glycated hemoglobin level.
Eur J Neurol. 2012 Jun; 19(6):884-91.EJ

Abstract

BACKGROUND AND PURPOSE

Previous studies demonstrated that post-stroke hyperglycemia was associated with poor outcome in non-diabetic patients. However, evidence was inconclusive amongst patients with diabetes. The aim of this study was to evaluate the relationship between initial glucose levels and mortality amongst patients with acute ischaemic stroke, and further, to assess whether the association varied by diabetes mellitus and glycated hemoglobin (HbA(1c)) levels.

METHODS

Data were collected from the medical records of 1277 first-ever stroke patients admitted to the emergency room between January 1, 2008 and June 30, 2009. Cox regression analysis was performed to assess the relationship between initial glucose level and mortality.

RESULTS

Compared with the lowest quartile of initial glucose level, a significant association with all-cause death [hazard ratio (HR), 2.18; 95% CI, 1.36-3.48] and cardiovascular death (HR, 1.91; 95% CI, 1.01-3.61) was seen in the highest quartile. In non-diabetic subgroup, those patients within the highest quartile of initial glucose level had a 3.29-fold relative risks (RR) [95% confidence interval (CI), 1.62-6.68] for all-cause and a 2.54-fold RR (95% CI, 1.43-8.77) for cardiovascular death compared with those within the lowest quartile. However, the association between initial glucose levels and the risk of death was not significant amongst those with diabetes (P for interaction = 0.01). In addition, the risk amongst patients with diabetes varied by the HbA(1c) levels.

CONCLUSIONS

A significant association was confirmed between initial glucose level and mortality in non-diabetic ischaemic stroke patients. The possible relationship between initial glucose level, HbA(1c) level, and mortality amongst ischaemic stroke patients with diabetes warrants further research.

Authors+Show Affiliations

Department of Rehabilitation Medicine, Mackay Memorial Hospital, Taipei.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22289016

Citation

Hu, G-C, et al. "Relationship of Initial Glucose Level and All-cause Death in Patients With Ischaemic Stroke: the Roles of Diabetes Mellitus and Glycated Hemoglobin Level." European Journal of Neurology, vol. 19, no. 6, 2012, pp. 884-91.
Hu GC, Hsieh SF, Chen YM, et al. Relationship of initial glucose level and all-cause death in patients with ischaemic stroke: the roles of diabetes mellitus and glycated hemoglobin level. Eur J Neurol. 2012;19(6):884-91.
Hu, G. C., Hsieh, S. F., Chen, Y. M., Hsu, H. H., Hu, Y. N., & Chien, K. L. (2012). Relationship of initial glucose level and all-cause death in patients with ischaemic stroke: the roles of diabetes mellitus and glycated hemoglobin level. European Journal of Neurology, 19(6), 884-91. https://doi.org/10.1111/j.1468-1331.2011.03647.x
Hu GC, et al. Relationship of Initial Glucose Level and All-cause Death in Patients With Ischaemic Stroke: the Roles of Diabetes Mellitus and Glycated Hemoglobin Level. Eur J Neurol. 2012;19(6):884-91. PubMed PMID: 22289016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of initial glucose level and all-cause death in patients with ischaemic stroke: the roles of diabetes mellitus and glycated hemoglobin level. AU - Hu,G-C, AU - Hsieh,S-F, AU - Chen,Y-M, AU - Hsu,H-H, AU - Hu,Y-N, AU - Chien,K-L, Y1 - 2012/01/31/ PY - 2012/2/1/entrez PY - 2012/2/1/pubmed PY - 2012/9/15/medline SP - 884 EP - 91 JF - European journal of neurology JO - Eur. J. Neurol. VL - 19 IS - 6 N2 - BACKGROUND AND PURPOSE: Previous studies demonstrated that post-stroke hyperglycemia was associated with poor outcome in non-diabetic patients. However, evidence was inconclusive amongst patients with diabetes. The aim of this study was to evaluate the relationship between initial glucose levels and mortality amongst patients with acute ischaemic stroke, and further, to assess whether the association varied by diabetes mellitus and glycated hemoglobin (HbA(1c)) levels. METHODS: Data were collected from the medical records of 1277 first-ever stroke patients admitted to the emergency room between January 1, 2008 and June 30, 2009. Cox regression analysis was performed to assess the relationship between initial glucose level and mortality. RESULTS: Compared with the lowest quartile of initial glucose level, a significant association with all-cause death [hazard ratio (HR), 2.18; 95% CI, 1.36-3.48] and cardiovascular death (HR, 1.91; 95% CI, 1.01-3.61) was seen in the highest quartile. In non-diabetic subgroup, those patients within the highest quartile of initial glucose level had a 3.29-fold relative risks (RR) [95% confidence interval (CI), 1.62-6.68] for all-cause and a 2.54-fold RR (95% CI, 1.43-8.77) for cardiovascular death compared with those within the lowest quartile. However, the association between initial glucose levels and the risk of death was not significant amongst those with diabetes (P for interaction = 0.01). In addition, the risk amongst patients with diabetes varied by the HbA(1c) levels. CONCLUSIONS: A significant association was confirmed between initial glucose level and mortality in non-diabetic ischaemic stroke patients. The possible relationship between initial glucose level, HbA(1c) level, and mortality amongst ischaemic stroke patients with diabetes warrants further research. SN - 1468-1331 UR - https://www.unboundmedicine.com/medline/citation/22289016/Relationship_of_initial_glucose_level_and_all_cause_death_in_patients_with_ischaemic_stroke:_the_roles_of_diabetes_mellitus_and_glycated_hemoglobin_level_ L2 - https://doi.org/10.1111/j.1468-1331.2011.03647.x DB - PRIME DP - Unbound Medicine ER -