BACKGROUND Elevated blood glucose levels following acute ischemic stroke have been associated with adverse clinical outcomes in thrombolytic and nonthrombolytic treated patients. The current study examined multiple blood glucose parameters and their association with modified Rankin Scale (mRS) score at 3 months following mechanical thrombectomy and hospital discharge. METHODS Acute ischemic stroke patients undergoing mechanical thrombectomy with a retrievable stent at two stroke centers were studied. Admission blood glucose level, maximum blood glucose during the hospital stay, and serial blood glucose measurements within the first 24 h of hospital admission were recorded. Variability in blood glucose level was represented by the standard deviation of the serial measurements within the first 24 h. The following demographic and clinical data was also collected: age, sex, baseline NIHSS score, onset-to-reperfusion times, hemoglobin A1c, and stroke mechanism. RESULTS 79 patients were identified; at 3 months, 35 patients had an mRS score of 0-2 and 44 had had an mRS of 3-6. Among the blood glucose variables, standard deviation of blood glucose in the first 24 h following admission and maximum blood glucose during hospital stay were significantly higher in the mRS 3-6 group. In multivariate logistic regression analysis, only the standard deviation of blood glucose remained significant (OR = 1.07, 95% CI = 1.02-1.11, p = 0.003) in a model that adjusted for admission NIHSS score (p = 0.016) and number of stent retriever passes (p = 0.042). CONCLUSIONS Greater blood glucose variability following acute ischemic stroke is associated with worse clinical outcome in patients undergoing mechanical thrombectomy.

中文翻译：

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急性缺血性中风机械血栓切除术后血糖与临床结果的关联。

背景急性缺血性中风后血糖水平升高与溶栓和非溶栓治疗患者的不良临床结果相关。目前的研究检查了机械血栓切除术和出院后 3 个月时的多个血糖参数及其与改良 Rankin 量表 (mRS) 评分的关系。方法 对两个中风中心接受可回收支架机械血栓切除术的急性缺血性中风患者进行研究。记录入院血糖水平、住院期间最高血糖以及入院前24小时内的连续血糖测量。血糖水平的变异性由前 24 小时内连续测量的标准差表示。还收集了以下人口统计和临床数据：年龄、性别、基线 NIHSS 评分、发病至再灌注时间、血红蛋白 A1c 和中风机制。结果 确定了 79 名患者；3 个月时，35 名患者的 mRS 评分为 0-2，44 名患者的 mRS 评分为 3-6。在血糖变量中，mRS 3-6组入院后24小时内的血糖标准差和住院期间的最高血糖显着较高。在多变量逻辑回归分析中，在根据入院 NIHSS 评分 (p = 0.016) 和支架数量进行调整的模型中，只有血糖的标准差仍然显着（OR = 1.07，95% CI = 1.02-1.11，p = 0.003）猎犬通过（p = 0.042）。结论 急性缺血性卒中后较大的血糖变异与接受机械血栓切除术的患者较差的临床结果相关。