Prevalance of Stress Hyperglycemia in Acute Cerebrovascular Accidents and Its Impact on Outcome

BACKGROUND: Cerebro vascular accident (CVA) continues to be the most common neurological disease in the developed and developing countries. It is well known by various studies that diabetic patients have more severe outcome and neurological disability after acute stroke than the non-diabetic patients. Stress hyperglycemia is also becoming a serious marker to affect the neurological outcome of these stroke patients. AIM OF THE STUDY: The aim of the study is to determine the prevalence of stress-induced hyperglycemia in patients with acute CVA and to study the blood sugar level and its correlation with the neurological outcome among the acute CVA patients on admission and discharge in a Government tertiary care Hospital. MATERIALS AND METHODS: It was a prospective and comparative study done in a govt. tertiary care hospital, Chennai. All those patients fulfilling the inclusion criteria presenting with Acute Cerebrovascular accident (CVA) to emergency department enrolled in the study. It included 126 adult patients with acute Cerebrovascular accident (CVA) of both the sexes. Adult patients (>18 years)presenting with acute CVA neurologically stratified based on the Modified Rankin Scale (mRS) and admission blood sugars noted. They were subdivided into 3 groups. Chi- square test / Fischer exact test was used to compare between 3 groups. RESULTS: 44 patients were hemorrhage stroke, 82 were ischemic stroke in our study. Normoglycemia was observed in i35 cases (27.8%), stress induced hyperglycemia i38 patients (30.2), diabetic were 53 (42.1%). CONCLUSION: Stress hyperglycemia in stroke was associated with a higher risk of poor functional outcomes in acute ischemic stroke. Hyperglycemia at stroke onset, without prior history of DM, have particularly poor prognosis than those with hyperglycemia in known diabetes