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Prognostic Signification of Admission Hyperglycemia among Acute Stroke Patients in Intensive Care Units in Kinshasa,the Democratic Republic of the Congo 被引量:1
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作者 Josée K.Tshituta Francois B.Lepira +12 位作者 Francois P.Kajingulu Jean Robert R.Makulo Ernest K.Sumaili Pierre Z.Akilimali Aliocha N.Nkodila Freddy M.Mbuyi Angele I.Masewu Stephane Mutombo Eric B.Amisi Jean Pierre M.Ilunga Wilfrid B.Mbombo Patrick M.Mukuna Adolphe M.Kilembe 《World Journal of Cardiovascular Diseases》 2019年第9期665-680,共16页
BACKGROUND AND AIM: Although admission hyperglycemia has been reported to be associated with unfavorable outcomes in acute stroke, little is known about this association in sub-Saharan Africa. Therefore, the aim of th... BACKGROUND AND AIM: Although admission hyperglycemia has been reported to be associated with unfavorable outcomes in acute stroke, little is known about this association in sub-Saharan Africa. Therefore, the aim of the present study was to assess the prognostic significance of admission hyperglycemia in the acute phase of stroke in Congolese patients. METHODS: In a multicenter prospective cohort study, consecutive patients with acute stroke were examined in 5 Emergency Rooms or Intensive Care Units of Kinshasa between July 15th, 2017 and March 15th, 2018. The severity of stroke was assessed at admission using the Glasgow Coma Scale. Stress hyperglycemia was defined as random blood glucose levels at admission > 140 mg/dL in patients without known type 2 diabetes mellitus (T2DM). The endpoint was 10-day all-cause in-hospital mortality. Survival (time-to-death) curves were built using the Kaplan Meier methods. Cox proportional analysis was used to identify predictors of 10-day all-cause in-hospital mortality. The predictive performance of blood glucose level to predict 10-day all-cause in-hospital mortality was assessed using ROC curve analysis. RESULTS: Out of 194 patients (mean age 58.7 ± 13.1 years;64% males, 74.7% light to moderate stroke severity;63.4% ischemic stroke) enrolled, 106 (54.6%) had admission hyperglycemia with 77 (72.6%) having stress hyperglycemia. Ninety four deaths (48.5%);mortality rate of 6 deaths per 100 person-days (95%CI 2.7 - 9.3) occurred during a median follow up time 6 (5 - 7) days equivalent to 1542 person-days. Independent predictors of 10-day all-cause in-hospital mortality were admission hyperglycemia regardless of diabetes status (aHR 3.77;95%CI 1.92 - 7.42;p < 0.001), GCS - 5.23;p = 0.001) and non-use of mechanical ventilation (aHR 1.97;95%CI 1.05 - 3.70;p = 0.034). Blood glucose concentrations (AUC 0.743;95%CI 0.672 - 0.814) had a better predictive performance for 10-day all-cause in-hospital mortality with an optimal value of 154 mg/dL (sensitivity 76.6% and specificity 70%). CONCLUSION: More than half of critically ill stroke patients exhibit admission hyperglycemia that impacts negatively on their survival in the acute phase highlighting thus the need for a better blood glucose control to improve outcomes. 展开更多
关键词 admission hyperglycemia STROKE Prognostic Significance Black Africans
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Impact of admission blood glucose levels on prognosis of elderly patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention 被引量:6
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作者 Ahmet Ekmekci Mahmut Uluganyan +4 位作者 Fatif Tufan Huseyin Uyarel Gurkan Karaca Seref Kul Barl(s) Gungor 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2013年第4期310-316,共7页
OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemi... OBJECTIVE:Admission hyperglycemia in acute myocardial infarction (MI) is related with increased in-hospital and long term mortality and major cardiac adverse events。 We aimed to investigate how admission hyperglycemia affects the short and long term outcomes in elderly patients >65 years) after primary percutaneous coronary intervention for ST elevation myocardial infarction。 METHODS:We retrospectively analyzed 677 consecutive elderly patients (mean age 72.2 ±5.4)。 Patients were divided into two groups according to admission blood glucose levels。 Group : low glucose group (LLG), glucose < 168 mg/dL; and Group 2: high glucose group (HGG), glucose >168 mg/dL。 RESULTS:In-hospital, long term mortality and in-hospital major adverse cardiac events were higher in the high admission blood glucose group (P <0.001)。 Multivariate regression analysis showed: Killip > 1, post-thrombolysis in MI <3 and admission blood glucose levels were independent predictors of in-hospital adverse cardiac events (P <0.001)。 CONCLUSIONS:Admission hyperglycemia in elderly patients presented with ST elevation myocardial infarction is an independent predictor of in-hospital major adverse cardiac events and is associated with in-hospital and long term mortality。 展开更多
关键词 admission hyperglycemia Elderly patients In-hospital mortality Long-term mortality Major adverse cardiac events
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Early Hyperglycemia in Diabetics as a Predictor of Disease Severity in COVID-19
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作者 Niaz Ahmed Shaikh Arshee Khan +3 位作者 Asnin Shah Rubina Inamdar Rania Abosalama Rafeh Jamal 《International Journal of Clinical Medicine》 2021年第12期543-550,共8页
<strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the... <strong>Background:</strong> Hyperglycemia is an important predictor of prolonged hospitalization and mortality. The objective of this study was to analyze the role of early hyperglycemia in predicting the severity of COVID-19 illness and mortality. <strong>Method:</strong> Retrospective study on 259 patients with COVID-19 with measurement of average glucose during 24 hours of admission. Association of Early Hyperglycemia categorized as <180 mg/dl or >180 mg/dl;was studied with mortality, requirement of ICU stay and prognostic markers. <strong>Results: </strong>Early hyperglycemia (>180 mg/dl) revealed a higher median value for CRP (109 mg/l [IQR;48 - 199]) in comparison to <180 mg/dl group (86 mg/l [IQR;26.3 - 153]) p = 0.03. ICU stay was higher in >180 mg/dl group;24 (15.9%) vs 14 patients (13%) [p = 0.51] in the <180 mg/dl group. Mortality in the group > 180 mg/dl was 8 (5.3%) while <180 mg/dl had a mortality rate of 4 (3.7%) [p = 0.547]. <strong>Conclusion:</strong> Hyperglycemia in the first 24 hours may anticipate an increased risk of ICU stay and a higher mortality rate. It may be a possible predictor of disease severity. 展开更多
关键词 admission hyperglycemia COVID-19 DIABETES Disease Severity
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入院高血糖对急性冠状动脉综合征预后影响的探讨
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作者 何泉 陈安宝 陈嘉勇 《临床荟萃》 CAS 2010年第8期651-653,共3页
目的初步探讨入院高血糖对急性冠状动脉综合征(ACS)预后相关因素的影响。方法109例ACS患者按血糖>7.8 mmol/L分为A组(n=68例),血糖≤7.8 mmol/L为B组(n=41例),比较两组临床情况和住院期间不良事件发生情况。以基线指标为自变量,以住... 目的初步探讨入院高血糖对急性冠状动脉综合征(ACS)预后相关因素的影响。方法109例ACS患者按血糖>7.8 mmol/L分为A组(n=68例),血糖≤7.8 mmol/L为B组(n=41例),比较两组临床情况和住院期间不良事件发生情况。以基线指标为自变量,以住院期间心血管事件发生率为因变量进行单因素分析和多元回归分析,探讨住院期间对心血管事件有显著性影响的危险因素。结果A组的心率、肌酐(Cr)、肌酸激酶同工酶(CK-MB)和肌钙蛋白I(cTnI)均高于B组,心率(116.9±10.8)次/min vs(105.1±21.2)次/min、Cr(142.0±8.9)μmol/L vs(109.0±10.1)μmol/L,CK-MB(0.38±0.01)μg/L vs(0.27±0.00)μg/L,cTnI(189.0±10.5)μg/L vs(86.0±9.8)μg/L(均P<0.01);两组心血管事件,包括心力衰竭(29.4%vs 26.8%)、心源性休克(4.4%vs 4.9%)、心律失常发生率(22.1%vs 34.1%)近期死亡发生率(2.9%vs 2.4%),差异无统计学意义(P>0.05);多元回归分析显示,心率、肌酐和血糖升高是住院期间心血管事件发生的危险因素。结论入院血糖水平升高是ACS患者风险发生的标志。为制定ACS患者强化血糖控制的安全性、可行性和有效性提供了参考。 展开更多
关键词 冠状动脉疾病 高血糖 预后
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