STRESS HYPERGLYCEMIA AS A PROGNOSTIC MARKER IN ACUTE ISCHAEMIC STROKE

Dr. Raghavendra Prasad B. N., Dr. Sandeep Reddy A.*, Dr. Prabhakar K., Dr. Thejdeep R., Dr. Surya Teja N., Dr. Karthik Reddy.A and Dr. Maveesh

ABSTRACT

OBJECTIVES: To evaluate the outcome in acute ischemic stroke patients with stress hyperglycemia in terms of mortality and functional recovery based on National Institute of Health Stroke Scale (NIHSS). MATERIALS AND METHODS: This is a case control study. 100 patients with CT evidence of acute ischaemic stroke meeting the inclusion and exclusion criteria's admitted to R.L. Jalappa Hospital and Research center attached to Sri Devaraj Urs Medical college, Tamaka, Kolar during may2014 to September 2015 were included in the study. The data was collected based on detailed history and clinical examination done as per the proforma along with few investigations like CT brain, RBG levels at admission, FBS, PPBS, HbA1c and RBG at discharge. Neurological status was assessed using NIHSS scale. Functional recovery was assessed based on the difference between NIHSS score on day of admission and 7th day. RESULTS: The maximum number of patients in our study were in the age group between 71 and 80 years. The mean age in both sexes was 62.71±14.09 years. male is to female ratio M:F is 1.38:1. Of the total100 patients 53 patients had stress hyperglycemia (RBG>140mg/dl) and 47 were normoglycemic (RBG<140). mean RBG value in stress hyperglycemic patients on admission was 183.06 ± 35.99 and mean RBG value in normoglycemic patients was 121.55 ± 14.03. Functional recovery which was better in normoglycemia patients compared to stress hyperglycemia patients. There was mortality in 5 patients with stress hyperglycemia. CONCLUSION: Functional recovery was better in the patients with normal RBG on admission than in patients having stress hyperglycemia. This suggests a possible association between stress hyperglycemia and poor outcome with stroke.

Keywords: stress hyperglycemia, Acute ischaemic stroke.