Journal of Diagnostics Concepts & Practice >

2021 , Vol. 20 >Issue 06: 562 - 566

DOI: https://doi.org/10.16150/j.1671-2870.2021.06.009

Original articles

The stress-induced hyperglycemia ratio in the prognosis prediction of patients with acute ischemic stroke one year after thrombolytic therapy

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  • Department of Neurocritical care, Xuchang Central Hospital, Henan University of Science and Technology, Henan Xuchang 461000, China

Received date: 2021-04-15

  Online published: 2021-12-25

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Abstract

Objective: To explore the association of stress-induced hyperglycemia ratio (SHR) and the prognosis of patients with acute ischemic stroke one year after thrombolytic therapy. Methods: A total of 262 patients with acute ischemic stroke, including 84 diabetics and 178 non-diabetics, who received thrombolytic therapy from January 2018 to January 2020 were enrolled in the study. The average levels of SHR calculated within 24 hours of admission were 0.859 and 0.914 in non-diabetics and diabetics, and patients were divided into low and high SHR group, with SHR below or above average level. The general clinical parameters and the mortality rate within 1 year after discharge were compared among diabetic and non-diabetics in low and the high SHR group. Cox univariate and multivariate regression were adopted in independent risk factor analysis for prognosis, and the Receiver operating curve (ROC) was plotted to evaluate the SHR in prognosis prediction. Results: Both diabetic and nondiabetic patients in high SHR group had higher NIHSS score, incidence of stress hyperglycemia, fasting blood glucose and glycosylated hemoglobin levels than patients in low SHR groups (P<0.05). The 1-year mortality rate of the non-diabetic and diabetic high SHR groups were 32.9%(28/85) and 48.9% (22/45), which were higher than their counterparts in low SHR groups, with 17.2%(16/93) and 17.9% (7/39) respectively ( χ2=5.910, P=0.015; and χ2=10.008, P=0.002). For patients with high SHR, the diabetics had higher 1-year mortality rate than the non-diabetics( χ2=4.075, P=0.044). NIHSS score, stress hyperglycemia, glycosylated hemoglobin, and SHR levels were all independent risk factors for the prognosis of patients 1 year after discharge. The ROC curve of SHR for adverse outcomes within one year after discharge revealed the AUC of 0.897 (95%CI=0.814-0.913) and 0.841(95%CI=0.804-0.861) in diabetics and non-diabetics with acute ischemic stroke respectively. Conclusions: High SHR is associated with decreased 1-year survival rate after thrombolytic therapy for acute ischemic stroke and is an independent risk factor for poor prognosis.

Key words： Acute ischemic stroke; Stress hyperglycemia ratio; Poor prognosis; Risk factors

Cite this article

LIANG Yali, ZHAO Haigang, XIANG Guangyu . The stress-induced hyperglycemia ratio in the prognosis prediction of patients with acute ischemic stroke one year after thrombolytic therapy[J]. Journal of Diagnostics Concepts & Practice, 2021 , 20(06) : 562 -566 . DOI: 10.16150/j.1671-2870.2021.06.009

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