Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Cerebrovasc Dis 2011;32:561–566 DOI: 10.1159/000331924 Persistent Hyperglycemia at 24–48 h in Acute Hyperglycemic Stroke Patients Is Not Associated with a Worse Functional Outcome G. Ntaios a C. Abatzi a M. Alexandrou a D. Lambrou a S. Chatzopoulos a M. Egli b J. Ruiz b N. Bornstein c P. Michel a Departments of a Neurology and b Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; c Department of Neurology, Elias Sourasky Medical Centre, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel January 1, 2003 and October 20, 2009, within 24 h after last well-being time. In the 421 patients (21.2%) with admission glucose 17.3 mmol/l, the proportion of patients with a favor- able outcome was not statistically significantly different be- tween the two groups (59.2 vs. 48.7%, respectively). In mul- tiple logistic regression analysis, unfavorable outcome was significantly associated with age (odds ratio, OR: 1.06, 95% confidence interval, 95% CI: 1.03–1.08 for every 10-year in- crease), National Institute of Health Stroke Score, NIHSS score, on admission (OR: 1.16, 95% CI: 1.11–1.21), prehospital mRS (OR: 12.63, 95% CI: 2.61–61.10 for patients with score 10), antidiabetic drug usage (OR: 0.36, 95% CI: 0.15–0.86) and glu- cose on admission (OR: 1.16, 95% CI: 1.02–1.31 for every 1 mmol/l increase). No association was found between per- sistent hyperglycemia at 24–28 h and outcome in either dia- betics or nondiabetics. Conclusions: In ischemic stroke pa- tients with acute hyperglycemia, persistent hyperglycemia ( 17.3 mmol/l) at 24–48 h after stroke onset is not associated with a worse functional outcome at 3 months whether the patient was previously diabetic or not. Copyright © 2011 S. Karger AG, Basel Key Words Poststroke hyperglycemia  Glucose management  Acute ischemic stroke  Diabetes mellitus Abstract Background: Recently, it was shown that the relation be- tween admission glucose and functional outcome after isch- emic stroke is described by a J-shaped curve, with a glucose range of 3.7–7.3 mmol/l associated with a favorable out- come. We tested the hypothesis that persistence of hyper- glycemia above this threshold at 24–48 h after stroke onset impairs 3-month functional outcome. Methods: We ana- lyzed all patients with glucose 17.3 mmol/l on admission from the Acute STroke Registry and Analysis of Lausanne (ASTRAL). Patients were divided into two groups according to their subacute glucose level at 24–48 h after last well-be- ing time (group 1: ^7.3 mmol/l, group 2: 17.3 mmol/l). A favorable functional outcome was defined as a modified Rankin Score (mRS) ^2 at 3 months. A multiple logistic re- gression analysis of multiple demographic, clinical, labora- tory and neuroimaging covariates was performed to assess predictors of an unfavorable outcome. Results: A total of 1,984 patients with ischemic stroke were admitted between Received: November 8, 2010 Accepted: August 2, 2011 Published online: November 18, 2011 George Ntaios, MD Neurology Service, Centre Hospitalier Universitaire Vaudois Rue du Bugnon 46 CH–1011 Lausanne (Switzerland) Tel. +30 6972 770 288, E-Mail ntaiosgeorge  @  yahoo.gr © 2011 S. Karger AG, Basel 1015–9770/11/0326–0561$38.00/0 Accessible online at: www.karger.com/ced