Hyperglycaemia in acute ischaemic stroke is associated with an increased 5-year mortality.
BACKGROUND
admission hyperglycaemia (HG) is associated with worse prognosis and higher mortality within 3 months after stroke. Reports on long-term mortality are inconsistent.


OBJECTIVE
to evaluate the influence of admission HG [blood glucose (BG) levels >8 mmol/L] on long-term mortality after ischaemic stroke (IS) and transient ischaemic attack (TIA).


METHODS
consecutive patients with IS or TIA, admitted from January 1997 until December 2002, were retrospectively screened. BG was measured within 3 days from onset of symptoms. Information on the date of death was obtained within 10 years after onset.


RESULTS
a total of 509 patients (78% IS; 22% TIA) were included. Admission HG was present in 28% and 18% of the IS and TIA patients, respectively (P = 0.05). Mean admission BG was 7.6 +/- 3.2 mmol/L in the IS and 6.7 +/- 2.3 mmol/L in TIA (P = 0.002). During a mean observation of 66 +/- 35 months, the overall 1- and 10-year mortality rate was 12% and 51% in IS compared to 4% and 38% in TIA patients (P = 0.004). Normoglycaemic IS patients had a longer median survival than those with HG (113 vs 84 months, P = 0.04). Admission HG did not affect the mortality rates in TIA patients.


CONCLUSIONS
admission HG is associated with greater mortality rates up to 5 years after stroke but does not influence the survival of TIA patients.
Kostulas
Nikolaos
N
Department of Neurology, Neuro-Angiological Research Center, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden. Nikolaos.Kostulas@ki.se
Markaki
Ioanna
I
Cansu
Helen
H
Masterman
Thomas
T
Kostulas
Vasilios
V
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D002545:Brain Ischemia / Q000401:mortality*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000401:mortality*; D002546:Ischemic Attack, Transient / Q000401:mortality*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D020521:Stroke / Q000401:mortality*; D055815:Young Adult
D001786:Blood Glucose