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A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
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Hyperglycemia predicts poststroke infections in acute ischemic stroke
Thomas P Zonneveld1, Paul J Nederkoorn1, Willeke F Westendorp1
1From the Department of Neurology (T.P.Z., P.J.N., W.F.W., M.C.B., D.v.d.B.), Academic Medical Center, Amsterdam; and the Department of Neurology (N.D.K.), Leiden University Medical Center, the Netherlands.
Neurology
|March 12, 2017
Summary
In nondiabetic patients with acute ischemic stroke, high blood sugar at admission predicts infections and worse outcomes. Poststroke infections did not alter this association, highlighting hyperglycemia as a key risk factor.
Area of Science:
- Neurology
- Endocrinology
- Infectious Diseases
Background:
- Admission hyperglycemia is a common complication in acute ischemic stroke.
- The relationship between hyperglycemia, poststroke infections, and functional outcomes requires further elucidation.
Purpose of the Study:
- To determine if admission hyperglycemia predicts poststroke infections.
- To investigate if poststroke infections modify the impact of admission hyperglycemia on functional outcomes in ischemic stroke patients.
Main Methods:
- Analysis of data from the Preventive Antibiotics in Stroke Study (PASS), a multicenter randomized controlled trial (n=2,550).
- Definition of admission hyperglycemia (blood glucose ≥7.8 mmol/L) and poststroke infection.
- Assessment of functional outcome using the modified Rankin Scale at 3 months.
Main Results:
- In 1,676 nondiabetic patients, 20% had admission hyperglycemia, which was associated with increased risk of poststroke infection (aOR 2.31) and worse functional outcome (aOR 1.40).
- Admission hyperglycemia also predicted increased 3-month mortality (aOR 2.11).
- In patients with diabetes, admission hyperglycemia was not linked to poststroke infection.
Conclusions:
- Admission hyperglycemia is an independent predictor of poststroke infections and poor functional outcomes in nondiabetic acute ischemic stroke patients.
- Poststroke infections do not mediate the effect of admission hyperglycemia on functional outcome.
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