Hyperglycemia as a Prognostic Factor In Acute Ischemic Stroke Patients
Condition: Acute Ischemic Stroke Patients
MeSH terms: Stroke; Ischemic Stroke; Cerebral Infarction; Hyperglycemia; Ischemia
Study type: Observational

Summary: 
      Background: Hyperglycemia is encountered in 20% to 40% of acute stroke patients, with or
      without a pre-morbid diagnosis of diabetes mellitus. Hyperglycemia is a risk factor for
      infarct expansion and poor outcome through the first 72 hours of onset in both diabetics and
      non-diabetics patients. This study was done to evaluate the glycemic status after acute
      ischemic stroke and assess its rule in influencing stroke outcome as regards the duration of
      hospital stay, motor deficit and mortality.

      Methods: This retrospective study was conducted in Elzaiton specialized hospital from June
      2016 to June 2017on 80 patients after approval of local medical ethical committee. Patients
      with acute ischemic stroke without other major comorbidities within 24 hours of onset of
      symptoms were included and divided into two groups, controlled group (Random blood suger not
      more than 150 mg/dl) and uncontrolled group ( Random blood suger more than 150 mg/dl). All
      patients were evaluated for GCS as a primary outcome and for hemorrhagic transformation,
      hospital stay duration, mechanical ventilation, need for vasopressors,hospital stay and
      mortality as secondary outcomes.
    

Detailed description: 
      Patients and Methods This study was prospective study conducted in Elzaiton specialized
      hospital and Ain Shams University from june2016 to June 2017on 80 patients after approval of
      local medical ethical committee

      All patients was subjected to the following

        1. Full clinical history …age, sex, weight and medical history

        2. GCS and motor deficit

        3. Random blood glucose level at admission and 4-6 times daily during hospital stay

        4. HbA1c on admission

        5. Hemodynamic monitoring

        6. Duration of hospital stay

        7. Thirty day mortality

        8. Other laboratory investigation to rule out other similar cause

        9. Follow up hemorrhagic transformation Study tools: Patients with acute ischemic stroke
           without other major comorbidities within 24 hours of onset of symptoms will be
           evaluated.

      On ICU admission the random blood sugar was recorded and categorized to less than 150mg/dl
      (accepted) and more than 150mg/dl(not controlled). Also serial Random blood sugar daily was
      recorded and categorized to accepted or good control if less than 150mg/dl and not controlled
      if more than 150mg/dl.

      Patients were divided into 2 groups Patients with accepted random blood sugar at admission
      and controlled blood sugar during hospital stay.

      Patients with increased random blood sugar at admission and poor blood sugar control during
      hospital stay.

      These data were collected and patients were observed as regards duration of hospital
      stay,hemorrhagic transformation, hospital stay duration and 30-days mortality
    

Intervention name(s): observational study
Intervention type(s): Other
Intervention description(s): observational study
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Patients with acute ischemic stroke without other major comorbidities within 24 hours of
        onset of symptoms will be evaluated.

        At ICU admission the random blood sugar was recorded and categorized to less than 150mg/dl
        (accepted) and more than 150mg/dl(not controlled). Also serial Random blood sugar daily was
        recorded and categorized to accepted or good control if less than 150mg/dl and not
        controlled if more than 150mg/dl.

        Patients were divided into 2 groups Patients with accepted random blood sugar at admission
        and controlled blood sugar during hospital stay (B) Patients with increased random blood
        sugar at admission and poor blood sugar control during hospital stay These data were
        collected and patients were observed as regards duration of hospital stay, motor deficit
        improvement or worsening using Rating scale for muscle strength