Association of Blood Glucose Levels with Stroke Type and Clinical Outcomes in a Tertiary Care Setting

Background: Hyperglycemia is a common metabolic disturbance in acute stroke patients and is associated with poor clinical outcomes. The relationship between the blood glucose level, the stroke subtypes, and clinical outcomes remains an area of research interest, particularly in low-resource settings. Methods: This isan observational study conducted at Sir Salimullah Medical College & Mitford Hospital, Dhaka, from May to November 2018. 100 acute stroke patients were recruited by purposive sampling. Demographic data, clinical presentation, comorbid conditions, and CT scan findings were recorded. Admission blood glucose levels >7.8 mmol/L in non-diabetic patients are defined as stress hyperglycemia. The patients were followed up for four weeks, with the Modified Rankin Scale utilized to assess outcomes. Data analysis was conducted using SPSS version 26. Results: Mean age was 58.37±6.23 years, with 64% male. Ischemic stroke is present in 74% of patients. Hyperglycemia (≥7.8 mmol/L) was present in 27% of patients with a higher frequency of hemorrhagic stroke (34.6%) compared to ischemic stroke (24.3%, p=0.03). Hyperglycemic patients had significantly higher rates of impaired consciousness (78% vs 61%, p=0.016) and headache (66% vs 45%, p=0.044). Logistic regression identified hemorrhagic stroke type (OR=1.72, 95% CI: 1.04-2.85, p=0.032), obesity (OR=1.88, 95% CI: 1.02-3.43, p=0.049), and lower GCS (OR=2.91, 95% CI: 1.34-6.33, p=0.003) as independent predictors of hyperglycemia. Conclusion: Hyperglycemia is significantly linked with hemorrhagic stroke and unfavorable clinical presentation. These findings emphasize the importance of blood glucose monitoring and control in acute stroke management, particularly in patients with hemorrhagic stroke.