Relationship between admission blood glucose level and prognosis in acute ischemic and hemorrhagic stroke patients

Introduction

The aim of this study was to investigate the relationship between blood glucose level measured on admission and hospital mortality with the Glasgow Coma Score (GCS) in ischemic and hemorrhagic stroke patients.

Methods

Those patients who experienced ischemic and hemorrhagic stroke and who arrived at the hospital within the first 3 hours after the beginning of the symptoms were included in the study. On arrival the GCS was detected. Blood glucose levels were determined for each patient. The patients were allocated as ischemic and hemorrhagic stroke groups on admission. In addition, ischemic and hemorrhagic stroke groups were allocated as GCS ≤ 8 and GCS ≥ 9 groups. The patients were observed in terms of mortality during their stay in the hospital. The data were compared using Kruskal–Wallis variance analysis and the Mann–Whitney U test with Bonferroni correction. P ≤ 0.05 was considered significant.

Results

We enrolled 113 patients (26 hemorrhagic, 87 ischemic stroke) in the study. The mean blood glucose level in the ischemic stroke and GCS ≤ 8 group (25 patients) was 189 ± 69.23 mg/dl on admission. The mean blood glucose level for the ischemic stroke and GCS ≥ 9 group (62 patients) was 165 ± 79.8 mg/dl. The mean blood glucose level of the hemorrhagic stroke and GCS ≤ 8 group (16 patients) was 291.7 ± 162.63 mg/dl. On admission, the mean blood glucose level of the hemorrhagic stroke and GCS ≥ 9 group (10 patients) was 141.8 ± 35.46 mg/dl. The mean blood glucose level of dead patients (n = 35) was 236.25 ± 128.88 mg/dl. A significant reverse relationship was found between GCS and blood glucose level (P = 0.00). A significant reverse relationship was found between GCS and blood glucose level for dead patients (P = 0.00).

Conclusion

In patients with ischemic and hemorrhagic stroke who referred to the emergency clinic within the first 3 hours after the stroke developed, a measured high glucose level on admission could be an indicator of bad prognosis and high hospital mortality.