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. 2024 Nov 26;16(1):285.
doi: 10.1186/s13098-024-01537-z.

Stress hyperglycemia is associated with early neurologic deterioration in patients with acute ischemic stroke after intravenous thrombolysis without hemorrhagic transformation

Junjie Lei #  1 , Yanfang Peng #  1 , Wenbin Li #  1 , Xiaofeng Chen  1 , Qian Fan  1 , Chenhao Liu  1 , Chaogang Tang  1 , Shijian Luo  1 , Weihua Mai  1 , Lei Zhang  2
Affiliations

Stress hyperglycemia is associated with early neurologic deterioration in patients with acute ischemic stroke after intravenous thrombolysis without hemorrhagic transformation

Junjie Lei et al. Diabetol Metab Syndr. .

Abstract

Background: This aimed to elucidate the impact of stress hyperglycemia on early neurological deterioration (END) in patients with acute non-cardiogenic cerebral infarction who did not experience hemorrhagic transformation following intravenous thrombolysis to identify risk factors associated with END.

Methods: This retrospective case-control study analyzed data from consecutive patients who received intravenous thrombolysis for acute ischemic stroke (AIS) without hemorrhagic transformation at the Stroke Center of The Fifth Affiliated Hospital of Sun Yat-sen University from January 2018 to February 2023. END was defined as an increase of more than 2 points on the National Institutes of Health Stroke Scale (NIHSS) within 7 days of admission.

Results: A total of 250 patients (56 males, 22.4%) were included, with a mean age of 63.34 ± 12.90 years. Of them, 41 were classified into the END group and 209 into the non-END group. Stress hyperglycemia ratio (SHR) demonstrated a significant correlation with END (r=-0.003, P = 0.003). HbA1c (OR = 0.68, 95% CI: 0.481-0.921) and SHR (OR = 0.00, 95% CI: 0.0-0.051) were independently associated with END. Receiver-operating characteristic (ROC) curve analysis indicated that SHR had a sensitivity of 79.9%, specificity of 88.8%, and an area under the curve (AUC) of 0.857 for predicting END.

Conclusions: SHR was significantly associated with END in patients with acute non-cardioembolic cerebral infarction who did not undergo hemorrhagic transformation after intravenous thrombolysis.

Keywords: Acute ischemic stroke; Early neurologic deterioration; Hemorrhagic transformation; SHR.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Fifth Affiliated Hospital of Sun Yat-sen University(K557). The requirement for individual consent was waived by the committee owing to the retrospective nature of the study. All procedures performed in this study involving human participants were in accordance with the ethical standards of The Fifth Affiliated Hospital of Sun Yat-Sen University committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Competing of interests: All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of SHR, HbA1c between the END group and the non-END group
Fig. 2
Fig. 2
Correlation heatmap related to END
Fig. 3
Fig. 3
Forest plot related to END
Fig. 4
Fig. 4
ROC curve for END
See this image and copyright information in PMC

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