A STUDY OF HYPERGLYCAEMIA AND ITS PROGNOSTIC EFFECT ON NEUROLOGICAL OUTCOME IN PATIENTS PRESENTING WITH ACUTE ISCHEMIC STROKE.

Dr. Sushil Kumar, Dr. Pramod Kumar Sinha, Dr. Ranjeet Kumar Singh

Abstract


Background: Cerebrovascular stroke is the third most common leading cause death worldwide after coronary heart disease (CAD) and cancer. The prevalence of stroke and its complications are increasing in last decades which make a large burden to patients, society and also treating physician. The neurological outcome of stroke is depending on various risk factor like age, sex, diabetes, hypertension, smoking, temperature, blood sugar level etc. Among these risk factor admission (stress) hyperglycaemia may adversely affect the outcome of stroke which can be modified by better blood sugar management both in diabetics and nondiabetics (stress hyperglycaemia). Now stress hyperglycaemia is also become a important marker which adversely affect the outcome stroke. In this study we evaluate correlation between blood sugar level and neurological outcome of ischaemic stroke on admission and after three months follow up.

Methods: It is a prospective and comparative study at A.N.M.M.C Gaya. 103 patients with ischemic stroke with age more than 40 years included. These patients National Institute of Health Stroke Score (NIHSS) and blood sugar level noted at time of admission. These patients divided in three group first group with normoglycemia second group with stress hyperglycaemia and third group with T2DM patients. These groups were again reassessed after 3 months with FBS, PPBS and neurological recovery by NHISS. Chi- square test / Fischer exact test was used to compare between 3 groups. A p-value of <0.005  was considered statistically significant. 

Results: The patients of first group(normoglycemic) had good functional recovery compared to second (stress hyperglycaemia) and third group (diabetes mellitus) groups (p <0.001) at 3 months.

Conclusions: High blood sugar level at the time of admission in patients of stroke may adversely affect the neurological outcome. So, blood sugar level at the time of admission may be used as important prognostic indicator for functional recovery.      

 

 


Keywords


Cerebrovascular accident, Stress hyperglycaemia, Normoglycemia, Diabetes mellitus, National Institute Of Health Stroke Score

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References


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