Influence of hyperglycemia on stroke mortality.

Background: The influence of hyperglycemia on stroke mortality is controversial. The aim of this study was to investigate the prognostic role of hyperglycemia and diabetes on short-term and long-term mortality in patients with acute ischemic stroke.

Methods: This retrospective cohort study included 416 acute ischemic stroke patients admitted to a tertiary hospital between July 1, 1995 and June 30, 1997. In-hospital mortality and 1-year mortality after discharge were the outcomes of the study. All patients were classified into four groups according to the glucose status and history of diabetes: group 1, normoglycemic without diabetes; group 2, normoglycemic with diabetes; group 3, hyperglycemic with diabetes and group 4, hyperglycemic without diabetes. Cochrane-Armitage trend test was used to assess the trend of mortality across the 4 groups. The influence of hyperglycemia on in-hospital and 1-year mortality were studied by logistic regression and Cox proportional hazards regression adjusting for confounders.

Results: The Cochrane-Armitage trend test showed there was a strong trend towards increasing in-hospital mortality across groups 1 to 4 (P < .001). Hyperglycemia without a history of diabetes was an independent predictor of in-hospital mortality, odds ratio 3.0 (95% confidence interval: 1.1-8.3; P = .035). Hyperglycemia (with or without diabetes) did not predict in-hospital mortality significantly. Neither hyperglycemia per se nor hyperglycemia without a history of diabetes were significant in predicting 1-year mortality.

Conclusion: Hyperglycemia without diabetes is independently associated with higher in-hospital mortality in patients with acute ischemic stroke. There was a trend to increasing in-hospital mortality across groups 1 to 4.