Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke

Abstract Background Hyperglycemia during acute ischemic stroke is associated with worse outcomes, and this glucose altitude may persist in the initial days. In this study, we investigate the effect of glucose fluctuations in the first 4 days in patients diagnosed with acute ischemic stroke and who u...

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Autores principales:	Sibel Ciplak, Ahmet Adiguzel, Unal Ozturk, Yahya Akalin
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Acute ischemic stroke Glucose Thrombolysis Thrombectomy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/868314e209614722a5fee764e416c23a
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spelling	oai:doaj.org-article:868314e209614722a5fee764e416c23a2021-11-28T12:13:40ZPrognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke10.1186/s41983-021-00416-y1687-8329https://doaj.org/article/868314e209614722a5fee764e416c23a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s41983-021-00416-yhttps://doaj.org/toc/1687-8329Abstract Background Hyperglycemia during acute ischemic stroke is associated with worse outcomes, and this glucose altitude may persist in the initial days. In this study, we investigate the effect of glucose fluctuations in the first 4 days in patients diagnosed with acute ischemic stroke and who underwent ivr-tPA ± interventional thrombectomy or only interventional thrombectomy on stroke prognosis. Study was designed bicentered retrospective case series. Patients older than 18 years were included and those suitable for acute treatment, treatment indications, contraindications, and treatment management of hyperglycemia were selected according to the 2018 American Stroke Association guidelines. The effect of fasting glucose values of patients in the first 4 days on admission and 24th hour NIHSS scores, duration of hospitalization, disability, mortality, and prognosis were analyzed. We aimed to demostred the effect of the first 4-day glucose values measured in patients treated in a stroke center on clinical prospect. Results One hundred and seventy-six patients were included in the study. Group 1 included 30 (17%) patients with severe clinical condition (NIHSS at admission ≥ 16), and Group 2 comprised 146 (83%) patients with moderate and mild clinical condition (NIHSS at admission < 16). The glucose values of Groups 1 and 2 were found as follows: day 1 (admission): 178.7 ± 10.3 mg/dl and 138.3 ± 54.9 mg/dl, day 2: 197.7 ± 99.8 mg/dl and 137.6 ± 51.8 mg/dl, day 3: 186.1 ± 97.6 mg/dl and 127.5 ± 50.0 mg/dl, and day 4: 169.2 ± 85.0 mg/dl and 126.7 ± 49.3 mg/dl (p < 0.05). Mortality risk of patients with glucose ≥ 200 mg/dl was 43.5% on day 1 (p > 0.05), 57.1% on day 2, 68.4% on day 3, and 76.5% on day 4 (p < 0.05). Conclusions The glucose level of patients in severe clinical condition peaked on the second day and that 4 days of resilient severe hyperglycemia is a negative risk factor for sequela and mortality.Sibel CiplakAhmet AdiguzelUnal OzturkYahya AkalinSpringerOpenarticleAcute ischemic strokeGlucoseThrombolysisThrombectomyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery, Vol 57, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Acute ischemic stroke Glucose Thrombolysis Thrombectomy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Acute ischemic stroke Glucose Thrombolysis Thrombectomy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Sibel Ciplak Ahmet Adiguzel Unal Ozturk Yahya Akalin Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
description	Abstract Background Hyperglycemia during acute ischemic stroke is associated with worse outcomes, and this glucose altitude may persist in the initial days. In this study, we investigate the effect of glucose fluctuations in the first 4 days in patients diagnosed with acute ischemic stroke and who underwent ivr-tPA ± interventional thrombectomy or only interventional thrombectomy on stroke prognosis. Study was designed bicentered retrospective case series. Patients older than 18 years were included and those suitable for acute treatment, treatment indications, contraindications, and treatment management of hyperglycemia were selected according to the 2018 American Stroke Association guidelines. The effect of fasting glucose values of patients in the first 4 days on admission and 24th hour NIHSS scores, duration of hospitalization, disability, mortality, and prognosis were analyzed. We aimed to demostred the effect of the first 4-day glucose values measured in patients treated in a stroke center on clinical prospect. Results One hundred and seventy-six patients were included in the study. Group 1 included 30 (17%) patients with severe clinical condition (NIHSS at admission ≥ 16), and Group 2 comprised 146 (83%) patients with moderate and mild clinical condition (NIHSS at admission < 16). The glucose values of Groups 1 and 2 were found as follows: day 1 (admission): 178.7 ± 10.3 mg/dl and 138.3 ± 54.9 mg/dl, day 2: 197.7 ± 99.8 mg/dl and 137.6 ± 51.8 mg/dl, day 3: 186.1 ± 97.6 mg/dl and 127.5 ± 50.0 mg/dl, and day 4: 169.2 ± 85.0 mg/dl and 126.7 ± 49.3 mg/dl (p < 0.05). Mortality risk of patients with glucose ≥ 200 mg/dl was 43.5% on day 1 (p > 0.05), 57.1% on day 2, 68.4% on day 3, and 76.5% on day 4 (p < 0.05). Conclusions The glucose level of patients in severe clinical condition peaked on the second day and that 4 days of resilient severe hyperglycemia is a negative risk factor for sequela and mortality.
format	article
author	Sibel Ciplak Ahmet Adiguzel Unal Ozturk Yahya Akalin
author_facet	Sibel Ciplak Ahmet Adiguzel Unal Ozturk Yahya Akalin
author_sort	Sibel Ciplak
title	Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
title_short	Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
title_full	Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
title_fullStr	Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
title_full_unstemmed	Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
title_sort	prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/868314e209614722a5fee764e416c23a
work_keys_str_mv	AT sibelciplak prognosticvalueofglucosefluctuationinpatientsundergoingthrombolysisorthrombectomyduetoacuteischemicstroke AT ahmetadiguzel prognosticvalueofglucosefluctuationinpatientsundergoingthrombolysisorthrombectomyduetoacuteischemicstroke AT unalozturk prognosticvalueofglucosefluctuationinpatientsundergoingthrombolysisorthrombectomyduetoacuteischemicstroke AT yahyaakalin prognosticvalueofglucosefluctuationinpatientsundergoingthrombolysisorthrombectomyduetoacuteischemicstroke
_version_	1718408151635591168

Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke

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