Volume 8, Issue 3, May 2020, Page: 133-137
Glycemic Control of Stroke Patients and Their Outcomes in a Comprehensive Stroke Center at a Tertiary Care Hospital: A Retrospective Cohort
Mohammad Amir Hossain, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Barbara Wyczesany, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Dwyer Jackie, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Swapnil Patel, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Khushboo Agarwal, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Rabail Soomro, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Brian Yung, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Arda Akoluk, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Stephen Martino, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Jennifer Cheng, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Raquel Ong, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Arif Asif, Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, USA
Received: Apr. 17, 2020;       Accepted: May 9, 2020;       Published: May 28, 2020
DOI: 10.11648/j.ajim.20200803.17      View  58      Downloads  56
Abstract
Background: Diabetes mellitus is one of the major modifiable risk factors for having a stroke and those who present with a stroke are found to have hyperglycemia. The association between hyperglycemia and stroke has been found in an increasing number of studies. Evidence indicates that persistent in-hospital hyperglycemia during the first 24 hours after acute ischemic stroke (AIS) is associated with worse outcomes than normoglycemia. We conducted a retrospective chart review to see the glycemic control of stroke patients and their hospital outcome over a 3-month period as part of a pre-evaluation assessment to develop a hyperglycemia protocol in the stroke unit. Methods: Institutional review board approval was obtained for this study. A total of 142 patients with acute stroke admitted in the Comprehensive Stroke Center at Jersey Shore University Medical Center over a 3-month period were included in this study. Demographic characteristics, comorbidities, glycemic patterns at admission and throughout the hospital stay, types of stroke, length of stay, NIH (National Institutes of Health) stroke scale on admission and discharge, discharge disposition and outcome were reviewed retrospectively. Statistical analysis was performed by SPSS and a nova with tukey as post-hoc analysis. For the graph, we used prism and for the regression analysis, stat disk was used. Results: Average age of the patients was 73 years, with male predominance (54%). Average BMI of the patients was 28.2. Most of the patients had an ischemic stroke (73%). Major comorbidities were hypertension (88%), dyslipidemia (66%), and diabetes (36%). About 8 of 143 (6%) patients were newly diagnosed with diabetes. Average Hba1C was 6.5. For a detailed statistical analysis, we divided patients into three groups by their blood glucose levels ranging from 80-140 mg/dl in group 1, 140-180 mg/dl in group 2, and more than 180 mg /dl in group 3. Then, we compared the length of stay (LOS), NIH scale admission/discharge, types of stroke and discharge disposition within the three groups. This study showed that the NIH stroke scale on admission in group 3 (blood glucose >180mg/dl) was higher compared to group 1 (blood glucose 80-140 mg/dl), with a p value of <0.01. Length of stay was more in group 3 compared to group 1 and 2, with a P value < 0.08. Conclusion: Although this study limited by smaller patient groups, but it concludes that higher blood glucose level associated with higher NIH stroke scale at admission and during discharge and have increased length of stay which is consistent with other similar studies
Keywords
Diabetes, Stroke, Hyperglycemia, Hypoglycemia
To cite this article
Mohammad Amir Hossain, Barbara Wyczesany, Dwyer Jackie, Swapnil Patel, Khushboo Agarwal, Rabail Soomro, Brian Yung, Arda Akoluk, Stephen Martino, Jennifer Cheng, Raquel Ong, Arif Asif, Glycemic Control of Stroke Patients and Their Outcomes in a Comprehensive Stroke Center at a Tertiary Care Hospital: A Retrospective Cohort, American Journal of Internal Medicine. Vol. 8, No. 3, 2020, pp. 133-137. doi: 10.11648/j.ajim.20200803.17
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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