Prognostic Implications and Temporal Trends of Glycemic Variability in Non-Diabetic Ischemic Stroke Patients

Overview

This study investigates the association of glycemic variability (GV) with all-cause mortality (ACM) in critically ill non-diabetic ischemic stroke patients. Elevated GV is linked to increased mortality risk, highlighting its potential as a dynamic metabolic marker for risk assessment in critical care.

Background

Glycemic variability is a critical factor in the management of critically ill patients, particularly those with non-diabetic ischemic stroke (ND-IS). Traditional glycemic indicators do not adequately reflect the dynamic changes in blood glucose levels that can impact patient outcomes. Understanding the relationship between GV and mortality can inform clinical strategies for risk assessment and management in this vulnerable population.

Data Highlights

Key Findings

• High glycemic variability (GV) is independently associated with increased risk of all-cause mortality (ACM) in ND-IS patients.
• 28-day mortality rates were significantly higher in the highest GV quartile (Q4) compared to the lowest (Q1).
• The hazard ratio for 28-day mortality in patients with high GV was 1.31 (95% CI 1.03–1.65).
• Mortality risk increased steeply beyond a GV of approximately 16–18% and plateaued around 36-38%.
• Incorporating GV into conventional severity models improved long-term prognostic accuracy.

Clinical Implications

Clinicians should consider glycemic variability as a significant prognostic marker in critically ill patients with non-diabetic ischemic stroke. Monitoring and managing GV may enhance risk stratification and inform treatment strategies to improve patient outcomes.

Conclusion

Elevated glycemic variability is a critical factor associated with increased mortality in critically ill ND-IS patients. This study underscores the importance of incorporating GV into clinical assessments to better manage and predict outcomes in this population.

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