Prognostic significance of hyperglycemia in acute stroke

Prognostic significance of hyperglycemia on short-term survival was evaluated in 72 patients with acute hemispheric stroke. All patients were admitted within 48 hours of onset, and the neurologic deficit was assessed by means of a standardized score. A computed tomogram was taken in all cases on admission. Mortality was higher in hyperglycemic patients with no history of diabetes mellitus (78%) than in diabetic (45%) and in normoglycemic nondiabetic (29%) patients. In nondiabetic patients, the glucose level correlated with the neurologic score and with lesion size on computed tomogram. Reactive hyperglycemia due to a major stress response accounts for the worse prognosis of these patients. This correlation was not found in diabetic patients. Preexisting hyperglycemia, as well as systemic complications, could explain the higher mortality in these patients compared with normoglycemic nondiabetic patients.