Deans' stroke musings: Long-term outcomes in older patients with hyperglycemia on admission for ischemic stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, October 13, 2017

Long-term outcomes in older patients with hyperglycemia on admission for ischemic stroke

Once again describing a problem but offering NO solution. Followup is needed that will never occur because we have NO stroke leadership to direct research.
https://www.mdlinx.com/internal-medicine/medical-news-article/2017/10/03/admission-diabetes-mellitus-ischemic-stroke/7470224/?

European Journal of Internal Medicine | October 03, 2017

Gorshtein A, et al. - The relationship between admission blood glucose (ABG) and mortality in older patients with or without diabetes mellitus (DM) hospitalized for acute ischemic stroke (AIS) was assessed in this study. The outcome of this study revealed that the elevated ABG is related to increased long-term mortality in older patients without DM hospitalized for AIS. Irrespective of DM status, elevated ABG was related to increased in-hospital mortality and length of stay (LOS).

Methods

For this study, they used observational data of 65 years or older patients, admitted for AIS between January 2011 and December 2013.
In this study, ABG levels were classified to categories: ≤ 70 (low), 70-110 (normal), 111-140 (mildly elevated), 141-180 mg/dl (moderately elevated) and >180 mg/dl (markedly elevated).
Main outcome was all-cause mortality at the end-of-follow-up.

Results

Total of 854 patients were included in this study cohort.
Among these 854 patients, 347 with (mean ± SD age 80 ± 8, 44% male), and 507 without DM (mean ± SD age 78 ± 8, 53% male).
A significant interaction was noticed between DM, ABG and mortality at end-of-follow-up (p ≤ 0.05).
In patients without DM there was a dose-dependent relationship between ABG category and mortality: adjusted hazard ratios (95% CI) compared to normal ABG were 1.8 (1.2-2.8), 2.9 (1.6-5.2) and 4.5 (2.1-9.7), respectively, for mildly, moderately and markedly elevated ABG.
In patients with DM there was no relationship amongst ABG and mortality.
No interaction was seen between DM, ABG and in-hospital mortality or length of stay (LOS).
Irrespective of DM status, compared to normal ABG levels, increased ABG category was related to increased in-hospital mortality: adjusted odds ratios were 3.9 (1.1-13.4), 7.0 (1.8-28.1), and 20.3 (4.6-89.6) with mildly, moderately and markedly elevated ABG, respectively.
Mean LOS was 6 ± 5, 7 ± 8, 8 ± 7, and 8 ± 8 days, respectively.