Usefulness of glycated hemoglobin A1c-based adjusted glycemic variables in diabetic patients presenting with acute ischemic stroke

被引:70
作者
Yang, Chih-Jen [1 ]
Liao, Wen-I [1 ]
Wang, Jen-Chun [1 ]
Tsai, Chia-Lin [2 ]
Lee, Jiunn-Tay [2 ]
Peng, Giia-Sheun [3 ]
Lee, Chien-Hsing [4 ]
Hsu, Chin-Wang [5 ,6 ]
Tsai, Shih-Hung [1 ]
机构
[1] Tri Serv Gen Hosp, Natl Def Med Ctr, Dept Emergency Med, 325 Sec 2,Cheng Kung Rd, Taipei, Taiwan
[2] Tri Serv Gen Hosp, Natl Def Med Ctr, Dept Neurol, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Hsinchu Branch, Dept Neurol, Hsinchu, Taiwan
[4] Tri Serv Gen Hosp, Natl Def Med Ctr, Dept Internal Med, Div Endocrinol & Metab, Taipei, Taiwan
[5] Taipei Med Univ, Coll Med, Sch Med, Dept Emergency Med, Taipei, Taiwan
[6] Taipei Med Univ, Wan Fang Hosp, Dept Emergency & Crit Med, Taipei, Taiwan
关键词
Acute ischemic stroke; Diabetes mellitus; Outcome assessment; Glycated hemoglobin; Hyperglycemia; glycemic gap; stress hyperglycemia ratio; stress-induced hyperglycemia; CRITICALLY-ILL PATIENTS; RAT THORACIC AORTA; STRESS HYPERGLYCEMIA; BLOOD-GLUCOSE; MONOCYTE ADHESION; CRITICAL ILLNESS; MORTALITY; ASSOCIATION; INSULIN; TRIAL;
D O I
10.1016/j.ajem.2017.03.049
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Acute hyperglycemia is a common condition among patients with diabetes who are admitted to the emergency department (ED) for acute ischemic stroke (AIS). Previous findings regarding the association between hyperglycemia at admission and adverse outcomes among patients with diabetes and AIS have been inconsistent. When investigating this association, it is necessary to consider premorbid blood glucose control. The objective of the current study was to assesswhether HbA1c-based adjusted glycemic variableswere associated with unfavorable outcomes among patients admitted to the hospital for AIS. We retrospectively analyzed data from 309 patients who were hospitalized for AIS at a single medical center in Taiwan between January 1, 2013, and October 31, 2015. We found that 1) HbA1c-based adjusted glycemic variables, including the glycemic gap and stress hyperglycemia ratio, were associated with both AIS severity and neurological status at discharge; additionally, 2) HbA1c-based adjusted glycemic variables showed superior discriminative power compared with acute hyperglycemia regarding the development of severe AIS. We conclude that both the glycemic gap and stress hyperglycemia ratio might be useful in assessing the disease severity and prognosis of patients presenting with AIS. Further prospective long-term follow-up studies should be performed to validate these findings. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:1240 / 1246
页数:7
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