Fasting Blood-Glucose Level and Clinical Outcome in Anterior Circulation Ischemic Stroke of Different Age Groups After Endovascular Treatment

Abstract

Objective: We aimed to analyze the association between fasting blood-glucose (FBG) level and 3-month functional outcome in anterior circulation ischemic stroke in different age groups after endovascular treatment (EVT).

Methods: We retrospectively analyzed the consecutive patients with acute ischemic stroke (AIS) receiving EVT from our department between July 2015 and March 2021. The patients were categorized into the older (≥60 years) and younger (<60 years) groups, and patients in each age group were dichotomized into favorable versus unfavorable outcomes according to the 3-month modified Rankin Scale (mRS) score.

Results: A total of 504 patients (286 males and 218 females) were included in our study. Three hundred ninety-two patients (77.8%) belonged to the group aged ≥60 years, and 112 (22.2%) belonged to the group aged <60 years. At the end of the study, 222 (56.6%) patients developed unfavorable outcomes in the older group and 31 (27.7%) showed unfavorable outcomes in the younger group. FBG level of the younger patients was significantly lower than that of older patients. In the older group, FBG level independently predicted a 3-month clinical unfavorable outcome with an odds ratio of 1.242 (95% confidence interval, 1.096-1.407; p = 0.001). However, the association was not found in the younger group (p = 0.376).

Conclusion: Higher FBG level is an independent risk factor for 3-month unfavorable outcome in the AIS patients aged ≥60 years receiving EVT, but no similar effect was seen in the group aged <60 years.

Keywords: acute ischemic stroke; endovascular treatment; fasting blood-glucose; hyperglycemia; outcome.

Figure 1

Inclusion flow chart.

Figure 2

Receiver-operating characteristic (ROC) curve showed predictive fasting blood-glucose for unfavorable outcome in the group aged ≥ 60 years.