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Evidence summaries

The Prognostic Value of Glucose Levels in Acute Stroke

Hyperglycaemia HASH(0x2fcfe80)8.6 mmol/l at any time within the first 48 hours from stroke onset may be associated with poor outcome. Level of evidence: "C"

A multicenter, prospective, observational cohort study 1 was conducted with a total of 476 subjects. The patients had had ischemic stroke within 24 hours. Capillary finger-prick glucose and stroke severity were determined on admission and 3 times a day during the first 48 hours. Poor outcome (modified Rankin Scale>2) was evaluated at 3 months. The predictive value of maximum capillary glucose was shown at any time within the first 48 hours with an area under the curve of 0.656 (95% CI 0.592 to 0.720) and pointed to HASH(0x2fcfe80)8.6 mmol/l as the optimal cutoff level for poor outcome at 3 months (53% sensitivity; 73% specificity). This point was associated with a 2.7-fold increase (95% CI 1.42 to 5.24) in the odds of poor outcome after adjustment for age, diabetes, capillary glucose on admission, infarct volume, and baseline stroke severity and with a 3-fold increase in the risk of death at 3 months (HR 3.80; 95% CI 1.79 to 8.10).

    References

    • Fuentes B, Castillo J, San José B et al. The prognostic value of capillary glucose levels in acute stroke: the GLycemia in Acute Stroke (GLIAS) study. Stroke 2009;40(2):562-8. [PubMed]

Primary/Secondary Keywords