Stress hyperglycemia is associated with in-hospital mortality in patients with diabetes and acute ischemic stroke.
Stress hyperglycemia is associated with in-hospital mortality in patients with diabetes and acute ischemic stroke.
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DOI：
10.1111/cns.13764
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发表时间：
2022-03
影响因子：
5.5
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Mi D;Li Z;Gu H;Jiang Y;Zhao X;Wang Y;Wang Y
应激性高血糖可能发生在急性重症脑血管疾病的糖尿病患者中，但其与卒中结局的关系的结果是相互矛盾的。本研究旨在探讨应激性高血糖与糖尿病合并急性缺血性脑卒中患者院内死亡之间的关系。所有数据均来自中国卒中中心联盟（CSCA）数据库，于2016年至2018年间从中国各地的bb300个中心收集。从数据库中提取患者的人口统计、临床表现和实验室数据。主要终点是院内死亡。计算空腹血糖（FBG）与糖化血红蛋白（HbA1c）之比，即应激性高血糖比（SHR），以确定急性缺血性卒中后的应激性高血糖。共纳入168,381例患者。平均年龄66.2±10.7岁，女性77,688例（43.0%）。患者分为两组：幸存者（n = 167,499）和非幸存者（n = 882），并根据其SHR四分位数分为四组（n = 42,090-42,099 /四分位数）。Q1、Q2、Q3和Q4四分位数分别有109例（0.26%）、142例（0.34%）、196例（0.47%）和435例（1.03%）患者死亡。与Q1患者相比，Q4患者的死亡风险更高（优势比(OR) = 4.02）（校正后OR = 1.80, 95%置信区间[CI] = 1.10-2.92，经传统心血管危险因素校正后p = 0.018）。ROC分析显示，SHR （AUC = 0.667, 95% CI: 0.647-0.686）对死亡率的预测价值优于空腹血糖（AUC = 0.633, 95% CI: 0.613-0.652）和糖化血红蛋白（AUC = 0.523, 95% CI: 0.504-0.543）。SHR可作为糖尿病患者急性缺血性脑卒中后预后的辅助参数。卒中合并糖尿病患者的高血糖与院内死亡的高风险相关。应激性高血糖率可作为急性缺血性脑卒中后糖尿病患者预后的辅助参数。卒中合并糖尿病患者的高血糖与院内死亡的高风险相关。
Stress hyperglycemia may occur in diabetic patients with acute severe cerebrovascular disease, but the results regarding its association with stroke outcomes are conflicting. This study aimed to examine the association between stress‐induced hyperglycemia and the occurrence of in‐hospital death in patients with diabetes and acute ischemic stroke. All data were from the Chinese Stroke Center Alliance (CSCA) database and were collected between 2016 and 2018 from >300 centers across China. Patients’ demographics, clinical presentation, and laboratory data were extracted from the database. The primary endpoint was in‐hospital death. The ratio of fasting blood glucose (FBG) to HbA1c was calculated, that is, the stress‐induced hyperglycemia ratio (SHR), to determine stress hyperglycemia following acute ischemic stroke. A total of 168,381 patients were included. The mean age was 66.2 ± 10.7, and 77,688 (43.0%) patients were female. The patients were divided into two groups: survivors (n = 167,499) and non‐survivors (n = 882), as well as into four groups according to their SHR quartiles (n = 42,090–42,099/quartile). There were 109 (0.26%), 142 (0.34%), 196 (0.47%), and 435 (1.03%) patients who died in the Q1, Q2, Q3, and Q4 quartiles, respectively. Compared with Q1 patients, the death risk was higher in Q4 patients (odds ratio (OR) = 4.02) (adjusted OR = 1.80, 95% confidence interval [CI] = 1.10–2.92, p = 0.018 after adjustment for traditional cardiovascular risk factors). The ROC analyses showed that SHR (AUC = 0.667, 95% CI: 0.647–0.686) had a better predictive value for mortality than that of fasting blood glucose (AUC = 0.633, 95% CI: 0.613–0.652) and HbA1c (AUC = 0.523, 95% CI: 0.504–0.543). The SHR may serve as an accessory parameter for the prognosis of patients with diabetes after acute ischemic stroke. Hyperglycemia in stroke patients with diabetes mellitus is associated with a higher risk of in‐hospital death. Stress‐induced hyperglycemia ratio may serve as an accessory parameter for the prognosis of patients with diabetes after acute ischemic stroke. Hyperglycemia in stroke patients with diabetes mellitus is associated with a higher risk of in‐hospital death.
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影响因子：
11.2
作者：
Parsons, MW;Barber, PA;Davis, SM
通讯作者：
Davis, SM
影响因子：
8.8
作者：
Egi, Moritoki;Bellomo, Rinaldo;Bailey, Michael
通讯作者：
Bailey, Michael
DOI：
10.1186/cc12514
发表时间：
2013-03-06
期刊：
Critical care (London, England)
影响因子：
--
作者：
Marik PE;Bellomo R
通讯作者：
Bellomo R
影响因子：
5.1
作者：
Hu, G. -C.;Hsieh, S. -F.;Chien, K. -L.
通讯作者：
Chien, K. -L.
DOI：
10.1016/j.jstrokecerebrovasdis.2016.03.018
发表时间：
2016-07-01
影响因子：
2.5
作者：
Lattanzi, Simona;Bartolini, Marco;Silvestrini, Mauro
通讯作者：
Silvestrini, Mauro