Journal of the neurological sciences · 2020
Elevated fasting blood glucose is predictive of the severity and poor outcome in nondiabetic patients with cerebral venous thrombosis.
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Wu Yating, Zhou Lixin, Yao Ming, Zhu Yicheng, Ni Jun, Cui Liying, Peng Bin
Аннотация
BACKGROUND AND PURPOSE: Although elevated fasting blood glucose (FBG) at admission is associated with poor outcome in patients with ischemic and hemorrhagic stroke, it has not been investigated in patients with cerebral venous thrombosis (CVT). We aimed to determine the correlation between elevated FBG and severity and outcome among CVT patients.
METHODS: Consecutive CVT patients between 2009 and 2019 were identified for this retrospective study. Patients with a history of diabetes mellitus or incomplete clinical data were excluded. Hyperglycemia was defined as FBG ≥ 6.1 mmol/L, further classified as mild (6.1-6.9 mmol/L) and severe hyperglycemia (≥7.0 mmol/L). The severity of CVT was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), CVT-related complications, and intracranial pressure. The outcome was assessed at discharge using mRS; mRS 3-6 indicated poor outcome.
RESULTS: Of 160 patients, 36 (22.5%) had hyperglycemia, and 24 (15%) had severe hyperglycemia. Baseline FBG positively correlated with NIHSS at admission (r = 0.55, P < .001). Patients with hyperglycemia had higher baseline mRS scores (P < .001), higher incidence of cerebral venous infarction (P = .039), intracranial hemorrhage (P = .005), coma (P < .001), and seizure (P = .010). Multivariate regression analysis revealed that patients with hyperglycemia had a higher risk of poor outcome (adjusted OR: 4.47; 95% CI: 1.05-18.95), and subgroup analysis showed that severe hyperglycemia (adjusted OR: 6.66; 95% CI: 1.35-32.81) was a stronger independent predictor of poor outcome.
CONCLUSIONS: Admission FBG was associated with severity of CVT, and elevated FBG is a predictor of short-term poor outcome among CVT patients.
METHODS: Consecutive CVT patients between 2009 and 2019 were identified for this retrospective study. Patients with a history of diabetes mellitus or incomplete clinical data were excluded. Hyperglycemia was defined as FBG ≥ 6.1 mmol/L, further classified as mild (6.1-6.9 mmol/L) and severe hyperglycemia (≥7.0 mmol/L). The severity of CVT was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), CVT-related complications, and intracranial pressure. The outcome was assessed at discharge using mRS; mRS 3-6 indicated poor outcome.
RESULTS: Of 160 patients, 36 (22.5%) had hyperglycemia, and 24 (15%) had severe hyperglycemia. Baseline FBG positively correlated with NIHSS at admission (r = 0.55, P < .001). Patients with hyperglycemia had higher baseline mRS scores (P < .001), higher incidence of cerebral venous infarction (P = .039), intracranial hemorrhage (P = .005), coma (P < .001), and seizure (P = .010). Multivariate regression analysis revealed that patients with hyperglycemia had a higher risk of poor outcome (adjusted OR: 4.47; 95% CI: 1.05-18.95), and subgroup analysis showed that severe hyperglycemia (adjusted OR: 6.66; 95% CI: 1.35-32.81) was a stronger independent predictor of poor outcome.
CONCLUSIONS: Admission FBG was associated with severity of CVT, and elevated FBG is a predictor of short-term poor outcome among CVT patients.