Hyperglycemia predicts poststroke infections in acute ischemic stroke.

Abstract:

OBJECTIVE:To investigate whether admission hyperglycemia predicts poststroke infections and, if so, whether poststroke infections modify the effect of admission hyperglycemia on functional outcome in ischemic stroke. METHODS:We used data from acute ischemic stroke patients in the Preventive Antibiotics in Stroke Study (PASS), a multicenter randomized controlled trial (n = 2,550) investigating the effect of preventive antibiotics on functional outcome. Admission hyperglycemia was defined as blood glucose ≥7.8 mmol/L and poststroke infection as any infection during admission judged by an expert adjudication committee. Functional outcome at 3 months was assessed with the modified Rankin Scale. RESULTS:Of 1,676 nondiabetic ischemic stroke patients, 338 (20%) had admission hyperglycemia. After adjustment for potential confounding variables, admission hyperglycemia was associated with poststroke infection (adjusted odds ratio [aOR] 2.31, 95% CI 1.31-4.07), worse 3-month functional outcome (common aOR 1.40, 95% CI 1.12-1.73), and 3-month mortality (aOR 2.11, 95% CI 1.40-3.19). Additional adjustment for poststroke infection in the functional outcome analysis, done to assess poststroke infection as an intermediate in the pathway from admission hyperglycemia to functional outcome, did not substantially change the model. In patients with recorded diabetes mellitus (n = 418), admission hyperglycemia was not associated with poststroke infection (aOR 0.49, 95% CI 0.15-1.58). CONCLUSIONS:In nondiabetic acute ischemic stroke patients, admission hyperglycemia is associated with poststroke infection and worse functional outcome. Poststroke infections did not modify the effect of admission hyperglycemia on functional outcome in ischemic stroke.

journal_name

Neurology

journal_title

Neurology

authors

Zonneveld TP,Nederkoorn PJ,Westendorp WF,Brouwer MC,van de Beek D,Kruyt ND,PASS Investigators.

doi

10.1212/WNL.0000000000003811

subject

Has Abstract

pub_date

2017-04-11 00:00:00

pages

1415-1421

issue

15

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000003811

journal_volume

88

pub_type

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