Background: Acute hyperglycemia predicts increased mortality after stroke. The aim of our study was to determine if acute stroke patients with hyperglycemia suffer from increased rate of in-hospital adverse events which could influence survival such as pneumonia, heart failure and myocardial infarction.
Methods: In a retrospective study with prospective follow-up, 689 patients with first-ever ischaemic stroke and high frequency of cardiovascular diseases were eligible. Follow-up period was 1-7 years (14 308 person-months).
Results: The frequency of in-hospital heart failure and nosocomial pneumonia was the highest in patients without pre-hospital diagnosis of diabetes mellitus and with fasting glucose >or=7 mmol/l (50% and 20.2%, respectively) and the lowest in patients without pre-hospital diagnosis of diabetes and fasting glucose <or=6.1 mmol/l (12.3% and 8.1%). On multivariate analysis fasting glucose was significantly associated with risk of in-hospital heart failure (OR: 1.12, 95% CI: 1.01-1.23), but not with pneumonia. Glucose level was an independent predictor of mortality only when statistical model did not include heart failure as a variable.
Conclusions: In stroke patients with hyperglycemia increased rate of heart failure could be responsible for higher mortality.