title: Increased admission and fasting glucose are associated with unfavorable short-term outcome after intra-arterial treatment of ischemic stroke in the MR CLEAN pretrial cohort.
abstract: BACKGROUND
  Limited data are available on the impact of fasting glucose on outcome after intra-arterial treatment (IAT). We studied whether hyperglycemia on admission and impaired fasting glucose (IFG) are associated with unfavorable outcome after IAT in acute ischemic stroke.
  
  
  METHODS
  Patients were derived from the pretrial registry of the MR CLEAN-trial. Hyperglycemia on admission was defined as glucose>7.8mmol/L, IFG as fasting glucose>5.5mmol/L in the first week of admission. Primary effect measure was the adjusted common odds ratio (acOR) for a shift in the direction of worse outcome on the modified Rankin Scale at discharge, estimated with ordinal logistic regression, adjusted for common prognostic factors.
  
  
  RESULTS
  Of the 335 patients in which glucose on admission was available, 86 (26%) were hyperglycemic, 148 of the 240 patients with available fasting glucose levels (62%) had IFG. Median admission glucose was 6.8mmol/L (IQR 6-8). Increased admission glucose (acOR 1.2, 95%CI 1.1-1.3), hyperglycemia on admission (acOR 2.6, 95%CI 1.5-4.6) and IFG (acOR 2.8, 95%CI 1.4-5.6) were associated with worse functional outcome at discharge.
  
  
  CONCLUSIONS
  Increased glucose on admission and IFG in the first week after stroke onset are associated with unfavorable short-term outcome after IAT of acute ischemic stroke.
authors.affiliation: Medisch Spectrum Twente, Haaksbergerstraat 55, 7513ER Enschede, The Netherlands. Electronic address: e.osei@mst.nl.
authors.forename: E
authors.initials: E
authors.lastname: Osei
authors.affiliation: Medisch Spectrum Twente, Haaksbergerstraat 55, 7513ER Enschede, The Netherlands. Electronic address: m.denhertog@mst.nl.
authors.forename: H M
authors.initials: HM
authors.lastname: den Hertog
authors.affiliation: Academisch Medisch Centrum, Postbus 22660, 1100 DD Amsterdam, The Netherlands. Electronic address: o.a.berkhemer@amc.uva.nl.
authors.forename: O A
authors.initials: OA
authors.lastname: Berkhemer
authors.affiliation: Erasmus Medisch Centrum, Postbus 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: p.fransen@erasmusmc.nl.
authors.forename: P S S
authors.initials: PS
authors.lastname: Fransen
authors.affiliation: Academisch Medisch Centrum, Postbus 22660, 1100 DD Amsterdam, The Netherlands. Electronic address: y.b.roos@amc.uva.nl.
authors.forename: Y B W E M
authors.initials: YB
authors.lastname: Roos
authors.affiliation: Maastricht Universitair Medisch Centrum, Postbus 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: debbie.beumer@mumc.nl.
authors.forename: D
authors.initials: D
authors.lastname: Beumer
authors.affiliation: Maastricht Universitair Medisch Centrum, Postbus 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: r.van.oostenbrugge@mumc.nl.
authors.forename: R J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.affiliation: St. Antonius Ziekenhuis, Postbus 2500, 3430 EM Nieuwegein, The Netherlands. Electronic address: w.schonewille@antoniusziekenhuis.nl.
authors.forename: W J
authors.initials: WJ
authors.lastname: Schonewille
authors.affiliation: Medisch Centrum Haaglanden, Postbus 432, 2501 CK Den Haag, The Netherlands. Electronic address: j.boiten@mchaaglanden.nl.
authors.forename: J
authors.initials: J
authors.lastname: Boiten
authors.affiliation: Ikazia Ziekenhuizen, Postbus 5009, 3008 AA Rotterdam, The Netherlands. Electronic address: aam.zandbergen@ikazia.nl.
authors.forename: A A M
authors.initials: AA
authors.lastname: Zandbergen
authors.affiliation: Erasmus Medisch Centrum, Postbus 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: p.j.koudstaal@erasmusmc.nl.
authors.forename: P J
authors.initials: PJ
authors.lastname: Koudstaal
authors.affiliation: Erasmus Medisch Centrum, Postbus 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: d.dippel@erasmusmc.nl.
authors.forename: D W J
authors.initials: DW
authors.lastname: Dippel
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002545:Brain Ischemia / Q000097:blood / Q000628:therapy*; D057510:Endovascular Procedures; D005215:Fasting; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010343:Patient Admission; D011379:Prognosis; D012042:Registries; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000628:therapy*; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Glucose; Hyperglycemia; IFG; Intra-arterial treatment; Thrombectomy