Prognostic value of admission plasma glucose in non-diabetic Nigerians with stroke.
Background and Purpose: Post stroke reactive hyperglycemia has been associated with increased mortality and poor recovery in nondiabetic patients. Few studies have demonstrated the relationship between stress hyperglycemia and stroke outcome in Africans. A prospective study was done to evaluate the prevalence of abnormal glucose metabolism in nondiabetic stroke patients and the risk of poor outcome in such patients.
Methods: Fasting plasma glucose was done after admission and patients were followed up for 30 days. Outcome was measured using the Modified Rankin scale based on the last score of each patient. Comprehensive literature search was done on relevant topics. Relative risks was calculated for plasma glucose above and below 140mg/dl. Results: One hundred patients were recruited. Thirty-nine percent had plasma glucose levels below 110mg/dl, 15%-between110-125.9 and 12%-between126-140 while 34% above 140 mg/dl. The percentage with poor outcome corresponding to plasma glucose levels were 53.9%, 46.7%, 58.3%, 72.6% respectively. The risk of death for patients with plasma glucose above 140mg/dl was 1.116 (95% CI, 0.769-1.618), and for patients ≤140 mg/dl was 0.742 (95% CI, 0.253-2.175). A moderate positive correlation was found between Admission plasma glucose and outcome (r = 0.330, p=0.042), indicating that admission plasma glucose moderately affects outcome.
Conclusions. There was a high rate of admission hyperglycemia in nondiabetic stroke patients. Post stroke hyperglycemia predicted increased risk of poor recovery in nondiabetic stroke survivors.
Key Words: • hyperglycemia • poor outcome • stroke • Nigerians