Effect of admission hyperglycaemia on short-term outcome in adult Nigerians with a first acute ischaemic stroke

Background: There is no information from a prospective study on the relationship between admission hyperglycaemia and stroke outcome in Nigerians. This study was designed to determine the impact of admission hyperglycaemia on short-term stroke outcome (case fatality rate and functional outcome) in adult Nigerians with acute ischaemic stroke. Methods: 100 consecutively attending first-ever acute ischemic stroke patients attending our tertiary facility within 72 hours of stroke onset were recruited. Stroke severity on the NIHSS and random blood glucose levels were documented on admission. The outcome measures (case fatality rate and functional status on the NIHSS in survivors) were assessed at 30 days from stroke onset. Results: The frequency of admission hyperglycaemia (random blood glucose ≥140mg/dL) was 34%. Baseline stroke severity on the NIHSS was worse in hyperglycaemic patients (median NIHSS 14) compared to normoglycaemic patients (median NIHSS 8). The 30-day case fatality rate was significantly higher in hyperglycaemic compared to normoglycaemic patients (41.2% vs. 21.2%, p<0.05). Although 60% of hyperglycaemic patients compared to 34.6% of normoglycaemic patients had a poor functional outcome, this did not reach statistical significance. Conclusions: Admission hyperglycaemia is a significant predictor of short-term case fatality but not poor functional outcome in first ever acute ischaemic stroke in Nigerians. These findings are relevant in view of the potential benefit of maintaining euglycaemia in the course of stroke management.