급성기 뇌경색 환자에서 뇌경색 아형에 따른 내원 시 혈당과 예후의 연관성

The Association between Neurological Prognosis and Serum Glucose Level by Stroke Subtype in Acute Ischemic Stroke

Background: Studies evaluating the prognostic value of admission glucose level (AGL) by stroke subtypes are rare. We aimed to evaluate the association between AGL and short-term outcome by each stroke subtype. Methods: We recruited 265 patients with acute infarction who were consecutively admitted to our hospital after acute stroke. We classified the patients into lacunar, large artery artherosclerosis (LAA) or cardioembolic infarction according to the TOAST stroke classification. AGL were measured at admission. The National Institutes of Health Stroke Scale (NIHSS) were evaluated initially and at 5 admission days. Results: Fifty patients were lacunar group, 190 were LAA group and 25 were cardioembolic group. All enrolled patients with higher AGL had significantly worse functional outcomes in acute stage compared to the low AGL group (P=0.005). In respect to stroke suptype, AGL was significantly associated with worse functional outcome in acute stage only in LAA group (P=0.002). There were no association between AGL and functional outcome in lacunar or cardioembolic infarction. Conclusion: The prognostic implication of AGL in acute ischemic stroke was different depending on each stroke subtype. Although AGL predicted worse functional outcome only in LAA group, it did not associate with functional outcome in the lacunar or cardioembolic infarction.