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

Research output: Contribution to journalArticle

1 Citation (Scopus)

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

Fingerprint

Observational Studies
Stroke
Prospective Studies
Prediabetic State
Recurrence
Qatar
Mortality
Coronary Artery Disease
Hypertension

Keywords

  • Diabetes
  • ischemic stroke
  • outcome
  • prognosis
  • recurrence

ASJC Scopus subject areas

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

Cite this

The Impact of Diabetes on Outcomes After Acute Ischemic Stroke : A Prospective Observational Study. / Akhtar, Naveed; Kamran, Saadat; Singh, Rajvir; Malik, Rayaz; Deleu, Dirk; Bourke, Paula J.; Joseph, Sujatha; Santos, Mark D.; Morgan, Deborah M.; Wadiwala, Faisal M.; Francis, Reny; Babu, Blessy M.; George, Pooja; Ibrahim, Rumissa; Garcia-Bermejo, Pablo; Shuaib, Ashfaq.

In: Journal of Stroke and Cerebrovascular Diseases, 01.01.2018.

Research output: Contribution to journalArticle

Akhtar, N, Kamran, S, Singh, R, Malik, R, Deleu, D, Bourke, PJ, Joseph, S, Santos, MD, Morgan, DM, Wadiwala, FM, Francis, R, Babu, BM, George, P, Ibrahim, R, Garcia-Bermejo, P & Shuaib, A 2018, '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
Akhtar, Naveed ; Kamran, Saadat ; Singh, Rajvir ; Malik, Rayaz ; Deleu, Dirk ; Bourke, Paula J. ; Joseph, Sujatha ; Santos, Mark D. ; Morgan, Deborah M. ; Wadiwala, Faisal M. ; Francis, Reny ; Babu, Blessy M. ; George, Pooja ; Ibrahim, Rumissa ; Garcia-Bermejo, Pablo ; Shuaib, Ashfaq. / The Impact of Diabetes on Outcomes After Acute Ischemic Stroke : A Prospective Observational Study. In: Journal of Stroke and Cerebrovascular Diseases. 2018.
@article{18f1501795a7448dbdfb68434b42f633,
title = "The Impact of Diabetes on Outcomes After Acute Ischemic Stroke: A Prospective Observational Study",
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.",
keywords = "Diabetes, ischemic stroke, outcome, prognosis, recurrence",
author = "Naveed Akhtar and Saadat Kamran and Rajvir Singh and Rayaz Malik and Dirk Deleu and Bourke, {Paula J.} and Sujatha Joseph and Santos, {Mark D.} and Morgan, {Deborah M.} and Wadiwala, {Faisal M.} and Reny Francis and Babu, {Blessy M.} and Pooja George and Rumissa Ibrahim and Pablo Garcia-Bermejo and Ashfaq Shuaib",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2018.11.003",
language = "English",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - The Impact of Diabetes on Outcomes After Acute Ischemic Stroke

T2 - A Prospective Observational Study

AU - Akhtar, Naveed

AU - Kamran, Saadat

AU - Singh, Rajvir

AU - Malik, Rayaz

AU - Deleu, Dirk

AU - Bourke, Paula J.

AU - Joseph, Sujatha

AU - Santos, Mark D.

AU - Morgan, Deborah M.

AU - Wadiwala, Faisal M.

AU - Francis, Reny

AU - Babu, Blessy M.

AU - George, Pooja

AU - Ibrahim, Rumissa

AU - Garcia-Bermejo, Pablo

AU - Shuaib, Ashfaq

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Diabetes

KW - ischemic stroke

KW - outcome

KW - prognosis

KW - recurrence

UR - http://www.scopus.com/inward/record.url?scp=85057978446&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057978446&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2018.11.003

DO - 10.1016/j.jstrokecerebrovasdis.2018.11.003

M3 - Article

C2 - 30545720

AN - SCOPUS:85057978446

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

ER -