The Impact of Diabetes on Outcomes After Acute Ischemic Stroke: A Prospective Observational Study

Naveed Akhtar, Saadat Kamran, Rajvir Singh, Rayaz Malik, Dirk Deleu, Paula J. Bourke, Sujatha Joseph, Mark D. Santos, Deborah M. Morgan, Faisal M. Wadiwala, Reny Francis, Blessy M. Babu, Pooja George, Rumissa Ibrahim, Pablo Garcia-Bermejo, Ashfaq Shuaib

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Abstract

Background: Stroke in diabetics may delay recovery and increases the risk of early recurrence of stroke. We compared the outcomes of patients (with and without diabetes) admitted with an acute ischemic stroke (AIS) in the state of Qatar. Patients and methods: We prospectively compared the clinical presentation, complications, discharge outcome, and stroke recurrence at 90 days in patients with and without diabetes. Results: Five thousand two hundred twenty-eight stroke patients were admitted between January 2014 and December 2017. Two thousand nine hundred sixty-one had confirmed AIS, 1695 (57.2%) had diabetes, 429 (14.5%) had prediabetes and 873 (29.5%) had no diabetes. Comparing diabetic patients to prediabetic and nondiabetics, they were significantly older (58.5 ± 11.9 versus 54.0 ± 12.9 versus 49.5 ± 13.8, P =.0001), had higher rates of hypertension (80.8% versus 67.4% versus 59.2%), previous stroke (18.0% versus 5.4% versus 6.2%), and coronary artery disease (12.9% versus 5.6% versus 5.0%; P =.001 for all). The percentage of patients with modified Rankin scale 3-6 at discharge (39.7% versus 32.6% versus 30.2%; P =.0001) and 90 days (26.7% versus 18.8% versus 21.4%, P =.001); 90-day mortality (6.2% versus 2.2% versus 5.2%; P =.03) and stroke recurrence (4.2% versus.7% versus 2.2%; P =.005) was significantly higher in diabetic patients. Conclusions: Patients with diabetes and AIS have more in-hospital complications, worse discharge outcomes, higher mortality and stroke recurrence at 90 days, compared to prediabetes and no diabetes.

Original languageEnglish
JournalJournal of Stroke and Cerebrovascular Diseases
DOIs
Publication statusAccepted/In press - 1 Jan 2018

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Keywords

  • Diabetes
  • ischemic stroke
  • outcome
  • prognosis
  • recurrence

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Akhtar, N., Kamran, S., Singh, R., Malik, R., Deleu, D., Bourke, P. J., Joseph, S., Santos, M. D., Morgan, D. M., Wadiwala, F. M., Francis, R., Babu, B. M., George, P., Ibrahim, R., Garcia-Bermejo, P., & Shuaib, A. (Accepted/In press). The Impact of Diabetes on Outcomes After Acute Ischemic Stroke: A Prospective Observational Study. Journal of Stroke and Cerebrovascular Diseases. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.11.003