Hyperglycemia predicts poststroke infections in acute ischemic stroke
| Autor: | Zonneveld, Thomas P., Nederkoorn, Paul J., Westendorp, Willeke F., Brouwer, Matthijs C., van de Beek, Diederik, Kruyt, Nyika D., Vermeij, J.-D., Zock, E., Hooijenga, I. J., Kerkhoff, H., Kleyweg, R. P., Kwa, V. I. H., Bosboom, J. L. W., Weisfelt, M., Remmers, M. J. M., van Dijk, E. J., Vermeij, F. H., Schreuder, A. H. C. M. L., Vermeer, S. E., ten Houten, R., Dippel, D. W. J., Kappelle, L. J., van der Worp, H. B., Merkies, I. S. J., de Bruijn, S. F. T. M., de Laat, K. F., Jellema, K., Keizer, K., de Rijk, M. C., Vermeij, A. J., Visser, M. C., Aerden, L. A. M., Schut, E. S., Reichman, L. J. A., de Gans, K., van den Berg-Vos, R. M., van Goor, M. P. J., Wijnhoud, A. D., van der Ree, T. C., Janmaat, M., van Orshoven, N. P., Manschot, S. M. |
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| Přispěvatelé: | Graduate School, Neurology, ACS - Amsterdam Cardiovascular Sciences, AII - Infectious diseases, ANS - Neuroinfection & -inflammation, AII - Amsterdam institute for Infection and Immunity, Other departments, ACS - Atherosclerosis & ischemic syndromes |
| Rok vydání: | 2016 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Infections law.invention Brain Ischemia Brain ischemia 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Modified Rankin Scale Predictive Value of Tests Diabetes mellitus Internal medicine Odds Ratio Medicine Humans 030212 general & internal medicine Stroke Aged Aged 80 and over Infection Control Chi-Square Distribution business.industry Ceftriaxone Odds ratio Middle Aged medicine.disease Anti-Bacterial Agents Predictive value of tests Hyperglycemia Physical therapy Female Neurology (clinical) business Chi-squared distribution 030217 neurology & neurosurgery |
| Zdroj: | Neurology, 88(15), 1415-1421 Neurology, 88(15), 1415-1421. Lippincott Williams and Wilkins |
| ISSN: | 1526-632X 1415-1421 0028-3878 |
| Popis: | Objective:To investigate whether admission hyperglycemia predicts poststroke infections and, if so, whether poststroke infections modify the effect of admission hyperglycemia on functional outcome in ischemic stroke.Methods:We used data from acute ischemic stroke patients in the Preventive Antibiotics in Stroke Study (PASS), a multicenter randomized controlled trial (n = 2,550) investigating the effect of preventive antibiotics on functional outcome. Admission hyperglycemia was defined as blood glucose ≥7.8 mmol/L and poststroke infection as any infection during admission judged by an expert adjudication committee. Functional outcome at 3 months was assessed with the modified Rankin Scale.Results:Of 1,676 nondiabetic ischemic stroke patients, 338 (20%) had admission hyperglycemia. After adjustment for potential confounding variables, admission hyperglycemia was associated with poststroke infection (adjusted odds ratio [aOR] 2.31, 95% CI 1.31–4.07), worse 3-month functional outcome (common aOR 1.40, 95% CI 1.12–1.73), and 3-month mortality (aOR 2.11, 95% CI 1.40–3.19). Additional adjustment for poststroke infection in the functional outcome analysis, done to assess poststroke infection as an intermediate in the pathway from admission hyperglycemia to functional outcome, did not substantially change the model. In patients with recorded diabetes mellitus (n = 418), admission hyperglycemia was not associated with poststroke infection (aOR 0.49, 95% CI 0.15–1.58).Conclusions:In nondiabetic acute ischemic stroke patients, admission hyperglycemia is associated with poststroke infection and worse functional outcome. Poststroke infections did not modify the effect of admission hyperglycemia on functional outcome in ischemic stroke. |
| Databáze: | OpenAIRE |
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