Ann Rehabil Med.  2021 Oct;45(5):359-367. 10.5535/arm.21124.

Post-stroke Hyperglycemia in Non-diabetic Ischemic Stroke is Related With Worse Functional Outcome: A Cohort Study

• Yoon JA
• Shin YI
• Kim DY
• Sohn MK
• Lee J
• Lee SG
• Lee YS
• Han EY
• Joo MC
• Oh GJ
• Park M
• Chang WH
• Kim YH

• KMID: 2521908
• DOI: http://doi.org/10.5535/arm.21124

Abstract

Objective
To investigate long-term and serial functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.
Methods
The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) is a large, multi-center, prospective cohort study of stroke patients admitted to participating hospitals in nine areas of Korea. From KOSCO, ischemic stroke patients without diabetes were recruited and divided into two groups: patients without diabetes without (n=779) and with post-stroke hyperglycemia (n=223). Post-stroke hyperglycemia was defined as a glucose level >8 mmol/L. Functional assessments were performed 7 days and 3, 6, and 12 months after stroke onset.
Results
There were no significant differences in baseline characteristics between the groups, except in the age of onset and smoking. Analysis of the linear correlation between the initial National Institutes of Health Stroke Scale (NIHSS) score and glucose level showed no significant difference. Among our functional assessments, NIHSS, Fugl-Meyer Assessment (affected side), Functional Ambulatory Category, modified Rankin Scale, and Korean Mini-Mental State Examination (K-MMSE) showed statistically significant improvements in each group. All functional improvements except K-MMSE were significantly higher in patients without post-stroke hyperglycemia at 7 days and 3, 6, and 12 months.
Conclusion
The glucose level of ischemic stroke patients without diabetes had no significant correlation with the initial NIHSS score. The long-term effects of stress hyperglycemia showed worse functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.

Keyword

Cohort studies, Recovery of function, Ischemic stroke, Hyperglycemia

Figure

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  Fig. 1. Flow diagram of this study. KOSCO, Korean Stroke Cohort for Functioning and Rehabilitation; IGT, impaired glucose tolerance; HbA1c, glycated hemoglobin.

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  Fig. 2. Comparison of (A) National Institutes of Health Stroke Scale (NIHSS) and (B) modified Rankin Scale (mRS) between the group with or without post-stroke hyperglycemia in non-diabetic ischemic stroke patients.

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