Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke
Background and PurposeHyperglycemia has been associated with unfavorable outcome of acute ischemic stroke, but this association has not been verified in patients with endovascular thrombectomy treatment. This study aimed to assess the impact of stress hyperglycemia ratio on early neurological deteri...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1094353/full |
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| author | Zheng Dai Zheng Dai Haiming Cao Feng Wang Lei Li Hongquan Guo Xiaohao Zhang Haichang Jiang Juehua Zhu Yongjun Jiang Dezhi Liu Gelin Xu Gelin Xu Gelin Xu |
| author_facet | Zheng Dai Zheng Dai Haiming Cao Feng Wang Lei Li Hongquan Guo Xiaohao Zhang Haichang Jiang Juehua Zhu Yongjun Jiang Dezhi Liu Gelin Xu Gelin Xu Gelin Xu |
| author_sort | Zheng Dai |
| collection | DOAJ |
| description | Background and PurposeHyperglycemia has been associated with unfavorable outcome of acute ischemic stroke, but this association has not been verified in patients with endovascular thrombectomy treatment. This study aimed to assess the impact of stress hyperglycemia ratio on early neurological deterioration and favorable outcome after thrombectomy in patients with acute ischemic stroke.MethodsStroke patients with endovascular thrombectomy in two comprehensive centers were enrolled. Early neurological deterioration was defined as ≥4 points increase of National Institutes of Health Stroke Scale (NIHSS) at 24 hours after endovascular procedure. Favorable outcome was defined as modified Rankin Scale (mRS) score of 0-2 at 90 days of stroke onset. Multivariate regression analysis was used to identify the predictors for early neurological deterioration and favorable outcome.ResultsAmong the 559 enrolled, 74 (13.2%) patients developed early neurological deterioration. The predictors for early neurological deterioration were high stress hyperglycemia ratio at baseline (OR =5.77; 95% CI, 1.878-17.742; P =0.002), symptomatic intracranial hemorrhage (OR =4.90; 95% CI, 2.439-9.835; P <0.001) and high NIHSS score after 24 hours (OR =1.11; 95% CI, 1.071-1.151; P <0.001). The predictors for favorable outcome were stress hyperglycemia ratio (OR =0.196, 95% CI, 0.077-0.502; P =0.001), age (OR =0.942, 95% CI, 0.909-0.977; P =0.001), NIHSS score 24 hours after onset (OR =0.757, 95% CI =0.693-0.827; P <0.001), groin puncture to recanalization time (OR =0.987, 95% CI, 0.975-0.998; P =0.025), poor collateral status before treatment (ASITN/SIR grade 0-3, OR =62.017, 95% CI, 25.920-148.382; P <0.001), successful recanalization (mTICI 2b or 3, OR =7.415, 95% CI, 1.942-28.313; P =0.001).ConclusionHigh stress hyperglycemia ratio may be related to early neurological deterioration and decreased likelihood of favourable outcomes after endovascular thrombectomy in patients with acute ischemic stroke. |
| first_indexed | 2024-04-10T20:14:13Z |
| format | Article |
| id | doaj.art-2505a2ae3c8d45d1bc186df5ccdc533c |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-10T20:14:13Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-2505a2ae3c8d45d1bc186df5ccdc533c2023-01-26T06:29:48ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-01-011410.3389/fendo.2023.10943531094353Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic strokeZheng Dai0Zheng Dai1Haiming Cao2Feng Wang3Lei Li4Hongquan Guo5Xiaohao Zhang6Haichang Jiang7Juehua Zhu8Yongjun Jiang9Dezhi Liu10Gelin Xu11Gelin Xu12Gelin Xu13Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, Jinling Hospital, First School of Clinical Medicine, Southern Medical University, Nanjing, ChinaDepartment of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Neurology, First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Neurology, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Neurology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Neurology, First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaBackground and PurposeHyperglycemia has been associated with unfavorable outcome of acute ischemic stroke, but this association has not been verified in patients with endovascular thrombectomy treatment. This study aimed to assess the impact of stress hyperglycemia ratio on early neurological deterioration and favorable outcome after thrombectomy in patients with acute ischemic stroke.MethodsStroke patients with endovascular thrombectomy in two comprehensive centers were enrolled. Early neurological deterioration was defined as ≥4 points increase of National Institutes of Health Stroke Scale (NIHSS) at 24 hours after endovascular procedure. Favorable outcome was defined as modified Rankin Scale (mRS) score of 0-2 at 90 days of stroke onset. Multivariate regression analysis was used to identify the predictors for early neurological deterioration and favorable outcome.ResultsAmong the 559 enrolled, 74 (13.2%) patients developed early neurological deterioration. The predictors for early neurological deterioration were high stress hyperglycemia ratio at baseline (OR =5.77; 95% CI, 1.878-17.742; P =0.002), symptomatic intracranial hemorrhage (OR =4.90; 95% CI, 2.439-9.835; P <0.001) and high NIHSS score after 24 hours (OR =1.11; 95% CI, 1.071-1.151; P <0.001). The predictors for favorable outcome were stress hyperglycemia ratio (OR =0.196, 95% CI, 0.077-0.502; P =0.001), age (OR =0.942, 95% CI, 0.909-0.977; P =0.001), NIHSS score 24 hours after onset (OR =0.757, 95% CI =0.693-0.827; P <0.001), groin puncture to recanalization time (OR =0.987, 95% CI, 0.975-0.998; P =0.025), poor collateral status before treatment (ASITN/SIR grade 0-3, OR =62.017, 95% CI, 25.920-148.382; P <0.001), successful recanalization (mTICI 2b or 3, OR =7.415, 95% CI, 1.942-28.313; P =0.001).ConclusionHigh stress hyperglycemia ratio may be related to early neurological deterioration and decreased likelihood of favourable outcomes after endovascular thrombectomy in patients with acute ischemic stroke.https://www.frontiersin.org/articles/10.3389/fendo.2023.1094353/fullacute ischemic strokeearly neurological deteriorationendovascular thrombectomylarge artery occlusionstress hyperglycemia ratio |
| spellingShingle | Zheng Dai Zheng Dai Haiming Cao Feng Wang Lei Li Hongquan Guo Xiaohao Zhang Haichang Jiang Juehua Zhu Yongjun Jiang Dezhi Liu Gelin Xu Gelin Xu Gelin Xu Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke Frontiers in Endocrinology acute ischemic stroke early neurological deterioration endovascular thrombectomy large artery occlusion stress hyperglycemia ratio |
| title | Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke |
| title_full | Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke |
| title_fullStr | Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke |
| title_full_unstemmed | Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke |
| title_short | Impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke |
| title_sort | impacts of stress hyperglycemia ratio on early neurological deterioration and functional outcome after endovascular treatment in patients with acute ischemic stroke |
| topic | acute ischemic stroke early neurological deterioration endovascular thrombectomy large artery occlusion stress hyperglycemia ratio |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1094353/full |
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