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[Predictors of one-year mortality in diabetic and nondiabetic patients with ischemic stroke]
Wojciech Turaj1, Agnieszka Słowik, Jacek Strojny
1Klinika Neurologii CM UJ w Krakowie. turaj@neuro.cm-uj.krakow.pl
Insights
Diabetes impacts stroke mortality predictors. While overall mortality was similar, diabetic patients with non-lacunar infarcts faced higher one-year death rates. Age and neurological deficit predicted death in both groups, with fever also a factor in non-diabetics.
Area of Science:
- Neurology
- Cardiology
- Endocrinology
Context:
- Ischemic stroke is a leading cause of death and disability worldwide.
- Diabetes mellitus is a significant comorbidity associated with increased stroke risk and potentially altered outcomes.
- Understanding predictors of mortality is crucial for effective patient management and prognosis.
Purpose:
- To compare the independent predictors of one-year mortality after ischemic stroke in patients with and without diabetes.
- To identify specific factors influencing post-stroke survival in diabetic versus non-diabetic populations.
Summary:
- This study analyzed 667 ischemic stroke patients (166 diabetic, 501 non-diabetic), assessing mortality predictors.
- While overall 30-day and one-year mortality were similar, diabetic patients with non-lacunar infarcts showed higher one-year mortality.
- Independent predictors for one-year mortality included older age and greater neurological deficit in diabetic patients.
- In non-diabetic patients, older age, greater neurological deficit, and elevated body temperature during hospitalization independently predicted one-year mortality.
Impact:
- Findings highlight the differential impact of stroke characteristics on mortality based on diabetic status.
- Identifies key prognostic factors for one-year survival post-ischemic stroke, aiding in risk stratification.
- Informs targeted interventions and closer monitoring for diabetic stroke patients, particularly those with non-lacunar infarcts.
Abstract:
The study was designed to compare the independent predictors of one-year mortality after ischemic stroke in patients with and without diabetes. We studied 667 patients with ischemic stroke, including 166 diabetic patients and 501 patients without diabetes. The diagnosis of ischemic stroke was confirmed in each case by computed tomography (CT) of the head. We collected data on patients' sex, age, and on the presence of major risk factors for stroke. The neurological deficit, including the disorders of consciousness, was assessed by Scandinavian Stroke Scale on admission. The body temperature was measured on admission and then every four hours during the first day of hospitalization. The outcome was measured by 30-day and one-year all cause mortality. The neurological deficit and the percentage of patients with large ischemic lesions in CT scanning were similar in patients with and without diabetes. Lacunar infarcts were more frequently seen in diabetics (30.1 vs 22.5%; p < 0.05). Diabetic and non-diabetic patients had similar 30-day and one-year mortality (16.3 vs. 17.6% and 41.0 vs. 35.1%, respectively; p = ns, chi2 test). One-year mortality among patients with non-lacunar infarcts was greater in diabetics (51.7%) than in non-diabetics (35.3%; p < 0.01). The multinomial logistic regression analysis revealed that older age and greater neurological deficit were independent predictors of death within one year after stroke in diabetic patients, while older age, greater neurological deficit and increased body temperature during the first day of hospitalization independently predicted one-year mortality in non-diabetic patients.
