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Association of Admission Hyperglycemia with Clinical Outcomes in Japanese Patients with Acute Large Vessel Occlusion Stroke: A post hoc Analysis of the Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism Japan Registry 2.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2021; Vol. 50 (1), pp. 12-19. Date of Electronic Publication: 2020 Nov 25. - Publication Year :
- 2021
-
Abstract
- Introduction: Admission hyperglycemia is an indicator of poor functional prognosis in acute stroke, but investigations of its prevalence and effects on the outcomes of acute large vessel occlusion in real-world, large-scale studies are limited, especially in Asian population.<br />Objective: We aimed to elucidate the relationship between admission hyperglycemia and outcomes in a prospective multicenter registry in Japan.<br />Methods: We analyzed data from the Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism (RESCUE) Japan Registry 2, which was a prospective, multicenter registry that enrolled patients from 46 centers in Japan. Admission hyperglycemia was defined as blood glucose level >140 mg/dL. The relationships between clinical outcomes and admission hyperglycemia were analyzed in all 1,932 assessable patients. A favorable functional outcome, defined as a modified Rankin Scale score of 0-2 at day 90, as well as mortality within 90 days and symptomatic intracranial hemorrhage (SICH) within 72 h, was analyzed. We performed subgroup analyses of the adjusted variables to investigate the association between hyperglycemia and favorable outcome in relation to each variable.<br />Results: Admission hyperglycemia was present in 687 (35.6%) of the assessable patients and in 420 (26.9%) of the 1,561 patients without diabetes. A favorable outcome was significantly less frequent in the hyperglycemia group than in the no-hyperglycemia group (33.2% vs. 47.6%, adjusted odds ratio [OR]: 0.60, 95% confidence interval [CI]: 0.47-0.76). The mortality rates were 12.8% and 6.8% in the hyperglycemia and no-hyperglycemia groups, respectively. The incidence of SICH within 72 h was higher in the hyperglycemia group than in the no-hyperglycemia group (4.4% vs. 1.9%, adjusted OR: 2.54, 95% CI: 1.36-4.82). Hyperglycemia was associated with unfavorable outcomes in almost all subgroups.<br />Conclusions: Admission hyperglycemia in Japanese patients with large vessel occlusion stroke is associated with an unfavorable functional outcome at 90 days, mortality within 90 days, and the occurrence of SICH within 72 h.<br /> (© 2020 S. Karger AG, Basel.)
- Subjects :
- Aged
Aged, 80 and over
Biomarkers blood
Female
Functional Status
Humans
Hyperglycemia blood
Hyperglycemia diagnosis
Hyperglycemia mortality
Incidence
Intracranial Hemorrhages epidemiology
Ischemic Stroke diagnosis
Ischemic Stroke mortality
Japan
Male
Prevalence
Recovery of Function
Registries
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Blood Glucose analysis
Endovascular Procedures adverse effects
Endovascular Procedures mortality
Hyperglycemia epidemiology
Ischemic Stroke therapy
Patient Admission
Thrombectomy adverse effects
Thrombectomy mortality
Thrombolytic Therapy adverse effects
Thrombolytic Therapy mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9786
- Volume :
- 50
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 33238274
- Full Text :
- https://doi.org/10.1159/000511679