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Title: | Using routine HbA1c measurements in stroke and the associations of dysglycaemia with stroke outcomes. | Austin Authors: | Lew, Jeremy F ;Thijs, Vincent N ;Churilov, Leonid ;Donnan, Geoffrey;Park, Warwick ;Robbins, Raymond J ;Hart, Graeme K ;Bladin, Christopher;Khoo, Kaylyn;Lau, Lik-Hui;Tan, Alanna ;Lam, Que T ;Johnson, Douglas F;Zajac, Jeffrey D ;Ekinci, Elif I | Affiliation: | Stroke Division, The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia Neurology Department of Administrative Informatics, Austin Health, Heidelberg, Victoria, Australia Intensive Care Health and Biomedical Informatics Centre, University of Melbourne, Australia Department of Neurosciences, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia Endocrinology Pathology Medicine (University of Melbourne) General Medicine |
Issue Date: | 18-Aug-2018 | Date: | 2018 | Publication information: | Journal of Diabetes and Its Complications 2018; online first: 18 August | Abstract: | Diabetes is a major risk factor for stroke. We aimed to investigate the prevalence of diabetes and pre-diabetes within a stroke cohort and examine the association of glycaemia status with mortality and morbidity. Inpatients aged ≥54 who presented with a diagnosis of stroke had a routine HbA1c measurement as part of the Austin Health Diabetes Discovery Initiative. Additional data were attained from hospital databases and Australian Stroke Clinical Registry. Outcomes included diabetes and pre-diabetes prevalence, length of stay, 6-month and in-hospital mortality, 28-day readmission rates, and 3-month modified Rankin scale score. Between July 2013 and December 2015, 610 patients were studied. Of these, 31% had diabetes while 40% had pre-diabetes. Using multivariable regression analyses, the presence of diabetes was associated with higher odds of 6-month mortality (OR = 1.90, p = 0.022) and higher expected length of stay (IRR = 1.29, p = 0.004). Similarly, a higher HbA1c was associated with higher odds of 6-month mortality (OR = 1.27, p = 0.005) and higher expected length of stay (IRR = 1.08, p = 0.010). 71% of this cohort had diabetes or pre-diabetes. Presence of diabetes and higher HbA1c were associated with higher 6-month mortality and length of stay. Further research is necessary to determine if improved glycaemic control may improve stroke outcomes. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/19524 | DOI: | 10.1016/j.jdiacomp.2018.08.013 | ORCID: | 0000-0003-2372-395X 0000-0002-6614-8417 0000-0001-6324-3403 0000-0002-9807-6606 |
Journal: | Journal of Diabetes and Its Complications | PubMed URL: | 30172697 | Type: | Journal Article | Subjects: | Diabetes mellitus Electronic Health Records Hemoglobin A glycosylated Prevalence Stroke |
Appears in Collections: | Journal articles |
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