Stress hyperglycemia predicts early neurological deterioration and poor outcomes in patients with single subcortical infarct

Abstract

Abstract Aim: The goal of this study was to determine whether the stress hyperglycemia ratio (SHR) is associated with early neurological deterioration (END) and poor outcomes in patients with single subcortical infarct (SSI). Methods: This study prospectively enrolled patients with SSI admitted between 2015 and 2021. END was defined as an increase of ≥ 2 points in the National Institutes of Health Stroke Scale (NIHSS) or ≥ 1 point in the motor items of the NIHSS within seven days of hospital admission. The modified Rankin Scale (mRS) was used to evaluate patient prognosis. Good and poor outcomes were defined as mRS scores ≤ 2 and > 2, respectively. The relationships between SHR and risk of END as well as outcomes were analyzed using multivariate logistic regression models. Results: A total of 1049 patients with SSI and an average age of 59.49 years met the inclusion criteria for the analysis. The incidence of END markedly increased with increasing SHR. Multivariate logistic regression analysis showed that a higher SHR was independently associated with END (OR 4.04, 95% CI, 2.43-6.69, P < 0.001) and 3-month poor outcomes (OR 2.34, 95% CI, 1.44-3.82, P = 0.003). A receiver operating characteristic analysis of the SHR based on the area under the curve showed a diagnostic accuracy equal or greater than other well-known predictors. Conclusion: SHR is a reliable predictor of END and poor outcomes in patients with SSI.