Abstract
Background: Patients with Diabetes Mellitus (DM) have been found to be at an increased risk of suffering a stroke. However, research on the impact of DM on stroke outcomes is limited. Objectives: We aimed to examine the influence of DM on outcomes in ischaemic (IS) and haemorrhagic stroke (HS) patients. Methods: We included 608,890 consecutive stroke patients from the Thailand national insurance registry. In-hospital mortality, sepsis, pneumonia, acute kidney injury (AKI), urinary tract infection (UTI) and cardiovascular events were evaluated using logistic regressions. Long-term analysis was performed on first-stroke patients with a determined pathology (n = 398,663) using Royston-Parmar models. Median follow-ups were 4.21 and 4.78 years for IS and HS, respectively. All analyses were stratified by stroke sub-type. Results: Mean age (SD) was 64.3 (13.7) years, 44.9% were female with 61% IS, 28% HS and 11% undetermined strokes. DM was associated with in-hospital death, pneumonia, sepsis, AKI and cardiovascular events (odds ratios ranging from 1.13-1.78, p<0.01) in both stroke types. In IS, DM was associated with long-term mortality and recurrence throughout the follow-up: HRmax (99%CI) at t=4108 days: 1.54 (1.27, 1.86) and HR(99%CI) = 1.27(1.23,1.32), respectively. In HS, HRmax (t=4108 days) for long-term mortality was 2.10 (1.87, 2.37), significant after day 14 post-discharge. HRmax (t=455) for long-term recurrence of HS was 1.29 (1.09, 1.53), significant after day 116 post-discharge. Conclusions: Regardless of stroke type, DM was associated with in-hospital death and complications, long-term mortality and recurrence.
Original language | English |
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Article number | 2 |
Number of pages | 12 |
Journal | Global Heart |
Volume | 15 |
Issue number | 1 |
Early online date | 6 Feb 2020 |
DOIs | |
Publication status | Published - 2020 |
Bibliographical note
ACKNOWLEDGEMENTSWAS received the Institute of Applied Health Sciences Aberdeen Summer Research Scholarship (ASRS) to carry out the research. The authors would like to thank Mr Jesus A Perdomo-Lampignano BSc for his assistance with graphics post-processing. We gratefully acknowledge the National Health Security Office (NHSO) of Thailand for providing the data.
Keywords
- diabetes mellitus
- stroke
- mortality
- recurrence
- complications
- Thailand