Mean Blood Glucose, Length of Hospital Stay, and Inpatient Complications in Patients with Acute Ischemic Stroke
Abstract Number: 1009-P
Authors: HARI BHATT, ALI RIZVI
Institutions: Columbia, SC
Results: Although the risk of ischemic cerebrovascular accident (CVA) is higher in patients with diabetes, the impact of hyperglycemia on hospital course of in acute ischemic stroke (AIS) is less clear. We studied the association of mean blood glucose (MBG) during the first 3 days of hospitalization with length of hospital stay (LOHS) and number of inpatient medical complications (NIC) in patients admitted with AIS. Records of hospitalized adult patients with a documented diagnosis of AIS over a 3-month period were reviewed for the following data: age, gender, MBG during the first 3 days, LOHS, type of diabetes treatment (non-pharmacologic, oral agent, or insulin), and major NIC (death, myocardial infarction, angina, new arrhythmia, deep vein thrombosis, urinary tract infection, urosepsis, pneumonia, and respiratory failure). Patients were divided into 3 groups based on their MBG: Group A <120 mg/dl, Group B 121-180 mg/dl, and Group C >180 mg/dl. 36 of 70 patients (51.4%) had a known history of diabetes. The average age was 67.8 years, 57% were female, and 60% African American. The % of patients treated with insulin in each group were 18.2, 62, and 94. The average LOHS per patient was 6.12, 7.38, and 11.5 days and there was a statistically significant association between the LOHS and increasing level of hyperglycemia (p<0.05). The average NIC per patient increased in the 3 groups (0.18, 0.29, and 1.0 respectively) and showed a significant relationship to increased MBG (p<0.01). We conclude that in individuals with AIS, high BG during the first 72 hours of hospitalization are a significant risk factor for LOHS and the occurrence of major complications, regardless of a known diagnosis of diabetes. Although prior studies have looked at the admission BG as a prognostic factor in stroke, our data extends this to the average BG during the first 3 days of hospital stay, likely representing both the ambient outpatient glycemia and early inpatient glucose control. Impact of glycemic and nonglycemic interventions in AIS during hospitalization need to be studied in order to reduce adverse outcomes, shorten hospital stay, and decrease the cost of care.