Loading...
Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy
Goyal, Nitin Tsivgoulis, Georgios Pandhi, Abhi Dillard, Kira Katsanos, Aristeidis H. Magoufis, Georgios Chang, Jason J. Zand, Ramin Hoit, Daniel Safouris, Apostolos
Goyal, Nitin
Tsivgoulis, Georgios
Pandhi, Abhi
Dillard, Kira
Katsanos, Aristeidis H.
Magoufis, Georgios
Chang, Jason J.
Zand, Ramin
Hoit, Daniel
Safouris, Apostolos
Abstract
Background and purpose: Higher admission serum glucose levels have been associated with poor outcomes in patients with acute ischemic stroke (AIS) treated with IV thrombolysis. We sought to evaluate the association of admission serum glucose with early outcomes of patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT).
Methods: Consecutive AIS patients due to ELVO treated with MT in three tertiary stroke centers were evaluated. The following outcomes were documented using standard definitions: symptomatic intracranial hemorrhage (sICH), complete reperfusion, mortality, functional independence (modified Rankin Scale (mRS) score of 0–2), and functional improvement (shift in mRS score) at 3 months. The association of admission serum glucose and admission hyperglycemia (>140 mg/dL) with outcomes was evaluated using univariable and multivariable binary and ordinal logistic regression models.
Results: 231 AIS patients with ELVO (mean age 62±14 years, 51% men, median admission National Institute of Health Stroke Scale score 16 points (IQR 12–21), median admission serum glucose 125 mg/dL (IQR 104–162)) were treated with MT. Admission hyperglycemia was associated with a lower likelihood of functional improvement (common OR 0.53; 95% CI 0.31 to 0.97; p=0.027) and higher odds of 3 month mortality (OR 2.76; 95% CI 1.40 to 5.44; p=0.004) in multivariable analyses adjusting for potential confounders. A 10 mg/dL increase in admission blood glucose was associated with a higher likelihood of sICH (OR 1.07; 95% CI 1.01 to 1.13; p=0.033) and 3 month mortality (OR 1.07; 95% CI 1.02 to 1.12; p=0.004) in multivariable models. There was no association between admission serum glucose or hyperglycemia and complete reperfusion.
Conclusions: Higher admission serum glucose and admission hyperglycemia are independent predictors of adverse outcomes in ELVO patients treated with MT.
Keywords
Date
2018
Type
Journal article
Journal
Journal of NeuroInterventional Surgery
Book
Volume
10
Issue
2
Page Range
112-117
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled