Hyperglycaemia in acute ischaemic stroke is associated with an increased 5-year mortality

Abstract

Background: admission hyperglycaemia (HG) is associated with worse prognosis and higher mortality within 3 months after stroke. Reports on long-term mortality are inconsistent. Objective: to evaluate the influence of admission HG [blood glucose (BG) levels >8 mmol/L] on long-term mortality after ischaemic stroke (IS) and transient ischaemic attack (TIA). Methods: consecutive patients with IS or TIA, admitted from January 1997 until December 2002, were retrospectively screened. BG was measured within 3 days from onset of symptoms. Information on the date of death was obtained within 10 years after onset. Results: a total of 509 patients (78% IS; 22% TIA) were included. Admission HG was present in 28% and 18% of the IS and TIA patients, respectively (P = 0.05). Mean admission BG was 7.6 ± 3.2 mmol/L in the IS and 6.7 ± 2.3 mmol/L in TIA (P = 0.002). During a mean observation of 66 ± 35 months, the overall 1- and 10-year mortality rate was 12% and 51% in IS compared to 4% and 38% in TIA patients (P = 0.004). Normoglycaemic IS patients had a longer median survival than those with HG (113 vs 84 months, P = 0.04). Admission HG did not affect the mortality rates in TIA patients. Conclusion: admission HG is associated with greater mortality rates up to 5 years after stroke but does not influence the survival of TIA patients. © The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.