The Effect of Hyperglycemia at Admission on Clinical Outcomes after Acute Stroke.

, Oh, Sang Hyang; , Hyun, Hwa Jin; , Lee, Young Jin; , Nam, Seung Ho; , Yoon, Jong Myung; , Bok, Soo Kyung

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2007;31(6):642-648.

Oh, Sang Hyang , Hyun, Hwa Jin , Lee, Young Jin , Nam, Seung Ho , Yoon, Jong Myung , Bok, Soo Kyung

Department of Rehabilitation Medicine and Myung-Gok Medical Science Institute, College of Medicine, Konyang University, Korea. chicchock@hanmail.net

급성기 뇌졸중 환자의 입원 시 고혈당증이 임상적 결과에 미치는 영향

오상향, 현화진, 이영진, 남승호, 윤종명, 복수경

건양대학교 의과대학 재활의학교실 및 명곡의과학연구소

Abstract

Objective
To clarify the issues about the importance of hyperglycemia in the acute stage of stroke as a poor predictor of clinical outcome, we analyzed the relationship between the glucose level in admission and clinical outcome in the acute stroke patients.
Method
Twenty-five patients with sudden onset of acute stroke with focal neurological deficit were included in this study. Clinical assessments consisted of the National Institutes of Health Stroke Scale (NIHSS) for neurological impairment and the Korean modified Bathel index (KMBI) for functional status. NIHSS and K-MBI were assessed at admission and at discharge. Plasma glucose level was measured at admission in all patients. Acute hyperglycemia at admission was defined as fasting plasma glucose level more than 140 mg/dl. Statistical analysis were used to compare variables and clinical outcome scores between the normoglycemic and hyperglycemic groups.
Results
For the patient with hyperglycemia at admission, the odds ratio for neurological improvement decreased (Ղ=-0.604) and the odds ratio for functional improvement decreased (Ղ=-0.553). However, control of the glucose level during the acute stroke was not significantly related to neurological and functional recovery (p＞0.05).
Conclusion
In patients with acute stroke, hyperglycemia at admission was associated with neurological and functional impairments. Therefore, we expect that strict control of hyperglycemia during the acute stroke would improve clinical outcomes. (J Korean Acad Rehab Med 2007; 31: 642-648)

Key Words: Acute stroke, Hyperglycemia, Clinical outcomes