Using routine HbA1c measurements in stroke and the associations of dysglycaemia with stroke outcomes.

Lew, Jeremy F; Thijs, Vincent N; Churilov, Leonid; Donnan, Geoffrey; Park, Warwick; Robbins, Raymond J; Hart, Graeme K; Bladin, Christopher; Khoo, Kaylyn; Lau, Lik-Hui; Tan, Alanna; Lam, Que T; Johnson, Douglas F; Zajac, Jeffrey D; Ekinci, Elif I

doi:10.1016/j.jdiacomp.2018.08.013

Title

Using routine HbA1c measurements in stroke and the associations of dysglycaemia with stroke outcomes.

Publication Date

2018-08-18

Author(s)

Lew, Jeremy F

Thijs, Vincent N

Churilov, Leonid

Donnan, Geoffrey

Park, Warwick

Robbins, Raymond J

Hart, Graeme K

Bladin, Christopher

Khoo, Kaylyn

Lau, Lik-Hui

Tan, Alanna

Lam, Que T

Johnson, Douglas F

Zajac, Jeffrey D

Ekinci, Elif I

Subject

Diabetes mellitus

Electronic Health Records

Hemoglobin A glycosylated

Prevalence

Stroke

Type of document

Journal Article

OrcId

0000-0003-2372-395X

0000-0002-6614-8417

0000-0001-6324-3403

0000-0002-9807-6606

#PLACEHOLDER_PARENT_METADATA_VALUE#

DOI

10.1016/j.jdiacomp.2018.08.013

Abstract

Diabetes is a major risk factor for stroke. We aimed to investigate the prevalence of diabetes and pre-diabetes within a stroke cohort and examine the association of glycaemia status with mortality and morbidity. Inpatients aged ≥54 who presented with a diagnosis of stroke had a routine HbA1c measurement as part of the Austin Health Diabetes Discovery Initiative. Additional data were attained from hospital databases and Australian Stroke Clinical Registry. Outcomes included diabetes and pre-diabetes prevalence, length of stay, 6-month and in-hospital mortality, 28-day readmission rates, and 3-month modified Rankin scale score. Between July 2013 and December 2015, 610 patients were studied. Of these, 31% had diabetes while 40% had pre-diabetes. Using multivariable regression analyses, the presence of diabetes was associated with higher odds of 6-month mortality (OR = 1.90, p = 0.022) and higher expected length of stay (IRR = 1.29, p = 0.004). Similarly, a higher HbA1c was associated with higher odds of 6-month mortality (OR = 1.27, p = 0.005) and higher expected length of stay (IRR = 1.08, p = 0.010). 71% of this cohort had diabetes or pre-diabetes. Presence of diabetes and higher HbA1c were associated with higher 6-month mortality and length of stay. Further research is necessary to determine if improved glycaemic control may improve stroke outcomes.

Link

link

Citation

Journal of Diabetes and Its Complications 2018; online first: 18 August

Jornal Title

Journal of Diabetes and Its Complications

Austin Health

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