[Influence of previous diagnosis of diabetes mellitus in the stroke severity and in-hospital outcome in acute cerebral infarction].
BACKGROUND
To analyze if previous diagnosis of diabetes influences stroke severity and in-hospital outcome in acute cerebral infarction (CI) patients.


METHODS
Observational study between 1998-2004 with inclusion of consecutive patients with CI. Risk factors, stroke subtype, severity on admission (Canadian Stroke Scale [CSS]), in-hospital complications, mortality, length of stay and stroke outcome (modified Rankin Scale [mRS]) in CI patients with and without previous diagnosis of diabetes were compared.


RESULTS
A total of 2,213 consecutive acute stroke patients; 661 with previous history of diabetes (29,9%) were included. These patients were older, had more rate of hypertension, dyslipidemia, coronary arterial disease, peripheral vascular disease and previous stroke than non-diabetic patients. Atherotrombotic and lacunar infarction were more frequent in diabetic patients. They also had more in-hospital complications as urinary tract infection (4.7 % vs 2.6 %; p < 0.05), multiple organ dysfunction syndrome (3.3% vs 1.8%; p<0.05), deteriorating stroke (6.1 % vs 3.4 %; p < 0.01), recurrent stroke (3.3% vs 1.7%; p<0.05) and increase of infarction volume (2.6 % vs 1.1%; p<0.05), with no differences in stroke severity at admission, mortality, length of in-hospital stay and stroke outcome. Previous history of diabetes was independently associated with in-hospital complications (OR: 1.377; CI 95%: 1.053-1.799).


CONCLUSIONS
Previous diagnosis of diabetes is not associated by itself to higher stroke severity on admission although a greater risk of in-hospital complications is found.
Ortega-Casarrubios
M A
MA
Unidad de Ictus, Servicio de Neurología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid.
Fuentes
B
B
San José
B
B
Martínez
P
P
Díez-Tejedor
E
E
D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000473:pathology*; D048909:Diabetes Complications / Q000473:pathology*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006761:Hospitals; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D020521:Stroke / Q000473:pathology*