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[Diabetes mellitus as a prognostic factor in ischemic cerebrovascular diseases]
T V Oliveira1, A M Gorz, P R Bittencourt
1Unidade de Neurologia Clínica, Hospital Nossa Senhora das Graças, Curitiba, Brasil.
Insights
Diabetes significantly worsens outcomes for patients with ischemic cerebral vascular disease (DCVI). Diabetic patients experienced longer hospital stays, more complications, and a higher mortality rate compared to non-diabetics.
Area of Science:
- Neurology
- Endocrinology
- Public Health
Context:
- Ischemic cerebral vascular disease (DCVI) poses a significant health burden.
- Diabetes mellitus is a prevalent comorbidity affecting various disease prognoses.
- Understanding the impact of diabetes on DCVI outcomes is crucial for patient management.
Purpose:
- To investigate the influence of diabetes mellitus on the prognosis of patients with ischemic cerebral vascular disease (DCVI).
- To compare clinical outcomes, complication rates, and survival between diabetic and non-diabetic DCVI patients.
Summary:
- Diabetic patients with DCVI had statistically longer hospital admissions and experienced more complications, including infectious complications, compared to non-diabetic patients.
- Mortality rates were significantly higher in the diabetic group, with 50% deaths by follow-up compared to 25% in non-diabetics.
- No significant differences were observed in in-hospital deaths or neurological status of survivors between the two groups.
Impact:
- Findings highlight the detrimental effect of diabetes on DCVI prognosis, emphasizing the need for aggressive management of diabetes in these patients.
- Results can inform clinical practice guidelines and public health strategies aimed at reducing DCVI morbidity and mortality in diabetic populations.
- This study underscores the importance of considering diabetes as a critical factor influencing long-term outcomes in ischemic stroke patients.
Abstract:
As part of a prospective study about 347 cases of ischemic cerebral vascular disease (DCVI) admitted to a general hospital 36 diabetic and 36 non-diabetic patients with similar sex, age and blood pressure were evaluated with the objective of assessing the effect of diabetes mellitus on prognosis in DCVI. All patients had various types of DCVI (thrombosis, thromboembolism or cardiac embolism). The diabetic patients had statistically longer admissions (p less than 0.05), more complications during admission (p less than 0.05), more infectious complications (p less than 0.01) and a greater number of deaths at the end of follow-up (p less than 0.05). After 377 +/- 429 (mean +/- standard deviation) days of follow-up, 50% of the diabetics had died while after 387 +/- 405 days 25% of the non-diabetics had died. Deaths in both groups occurred in average at the 8th month after the vascular event that led to the first admission. There were no differences with respect to the number of deaths during admission or to neurological conditions of the survivors at the end of the first admission or at the end of follow-up.