STRESS HYPERGLYCEMIA AND MORTALITY IN PATIENTS WITH ACUTE ISCHEMIC STROKE.

Abstract

Objectives: The objective of the study was to compare mortality and morbidity in patients of acute ischemic stroke presenting with and without stress hyperglycemia. Background: A high proportion of patients suffering an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a preexisting diagnosis of diabetes. Place and Duration of Study: This study was carried out in neurology units of Military Hospital Rawalpindi, and in Combined Military Hospital Rawalpindi, both are tertiary referral hospitals. The duration of study was from 1st March to 25th August, 2004. Results: In the hyperglycemic group, out of 50 patients, 22 (44%) died within 04 weeks of stroke. In the control group, 10 (20%) out of 50 patients expired. The study showed a statistically significant relative risk of 2.2 in case of hyperglycemics as compared to normoglycemics. In the study group, mortality rate was higher in males, 14 (63%) out of 22 as compared to females of 8 (36.36%). Even in survivors, functional outcome at 01 month was worse in the hyperglycemic group. Patients with stress hyperglycemia were 0.4 times less likely to improve as compared to normoglycemics. Conclusion: In non-diabetic patients suffering from an ischemic stroke, moderately elevated glucose levels were associated with a more than 2-fold higher risk of short-term mortality compared with lower glucose levels. Even in survivors, stress hyperglycemia was associated with a poor functional outcome after acute ischemic strokes.