Glucose Parameters And Clinical Outcomes After Mechanical Thrombectomy For Acute Large Vessel Occlusion Stroke

Objective:Hyperglycemia is associated with poor outcomes in patients with acute ischemic stroke treated by mechanical thrombectomy(MT).In this study,we investigated the predictive power of admission blood glucose(ABG),fasting blood glucose(FBG),and glycated hemoglobin(HbAlc)in patients with acute large vessel occlusion(ALVO)stroke undergoing MT.Methods:The study retrospectively reviewed the data of 329 consecutive ALVO stroke patients treated by MT.All patients were divided into either a favorable outcome group(mRS 0-2)or poor outcome group(mRS 3-6)according to the 3-month mRS score and compared between groups.Multivariate logistic regression analysis was performed to investigate the predictors of poor functional outcome.Receiver operating characteristic(ROC)curve was performed to identify the predictive power of admission random glucose,fasting glucose,and HbA1c for poor functional outcomes in patients with ALVO stroke undergoing MT.Furthermore,subgroup analyses were performed for both diabetic and nondiabetic patients.Results:ABG and FBG were significantly higher in the poor outcome group than in the favorable outcome group,while there was no significant group difference in HbAlc.Multiple logistic regression analysis demonstrated that ABG(odds ratio[OR]1.196,95% confidence intervals[CI]1.072-1.333,P<0.001)and FBG(OR 1.272,95% CI 1.144-1.416,P<0.001)were independent predictors of 3-month poor functional outcome;however,HbA1c(OR 1.178,95% CI 0.982-1.413,P=0.078)could not predict poor functional outcomes.ROC analysis showed that FBG has a higher predictive power than ABG(areas under the ROC curve[AUCs]:0.689 vs.0.624,P=0.037) and HbA1c(AUCs:0.689 vs.0.541,P<0.001)for poor functional outcome.For diabetic and non-diabetic patients,the predictive power of FBG and ABG was similar,(0.701 vs.0.651,P=0.365)and(0.692 vs.0.611,P=0.079),respectively,but the predictive power of FBG was higher than HbA1c in both groups,(0.701 vs.0.554,P=0.002)and(0.692 vs.0.508,P=0.002),respectively.Conclusion:ABG and FBG are independent predictors of poor functional outcome in patients with acute ischemic stroke undergoing MT,and FBG has a higher predictive power than ABG.