Netherlands: High-serum blood sugar on admission increases risk of intracranial hemorrhage in stroke patients who underwent endovascular treatment, finds a recent study in the AHA journal Stroke. Also, it is associated with poor functional outcome.
Increased admission glucose is a predictor of poor outcome after stroke. Jonathan M. Coutinho, University of Amsterdam, Amsterdam, the Netherlands, and colleagues assessed the association between glucose concentrations and clinical outcomes in patients who underwent endovascular treatment.
For the purpose, the researchers selected consecutive adult patients from the MR CLEAN Registry. with a large vessel occlusion of the anterior circulation who underwent endovascular treatment and for whom admission glucose levels were available. The researchers assessed the association between admission glucose and the modified Rankin Scale score at 90 days, symptomatic intracranial hemorrhage and successful reperfusion rates.
Hyperglycemia was defined as admission glucose ≥7.8 mmol/L.
Of 3637 patients in the MR CLEAN Registry, 2908 were included. Median admission glucose concentration was 6.8 mmol/L (interquartile range, 5.9–8.1) and 882 patients (30%) had hyperglycemia.
Key findings of the study include:
Hyperglycemia on admission was associated with a shift toward worse functional outcome (median modified Rankin Scale score 4 versus 3; adjusted common odds ratio, 1.69, increased mortality (40% versus 23%; adjusted odds ratio, 1.95), and an increased risk of symptomatic intracranial hemorrhage (9% versus 5%; adjusted odds ratio, 1.94) compared with nonhyperglycemic patients.
The association between admission glucose levels and poor outcome (modified Rankin Scale score 3–6) was J-shaped.
Hyperglycemia was not associated with the rate of successful reperfusion nor did successful reperfusion modify the association between glucose and functional outcome.
"Our results show that increased admission glucose is associated with poor functional outcome and an increased risk of symptomatic intracranial hemorrhage after endovascular treatment," concluded the authors.
The study, "High Admission Glucose Is Associated With Poor Outcome After Endovascular Treatment for Ischemic Stroke," is published in the AHA journal Stroke.
DOI: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.029944