To examine whether admission hyperglycemia independently predicts unfavorable discharge outcomes and to quantify adherence to SHINE trial-aligned management standards.
Approach:
Study Design: Single-center retrospective cohort study including 218 adults with acute ischemic stroke admitted between July 1 and December 31, 2023.
Outcomes: Co-primary outcomes were unfavorable discharge modified Rankin Scale (mRS) scores of 3–6 and in-hospital death.
Analysis: Multivariable logistic regression adjusted for nine covariates; Bonferroni correction applied.
Key Findings:
Admission hyperglycemia (51.7%) was associated with unfavorable mRS (adjusted OR 3.43, 95% CI 1.33–8.87, p = 0.011).
Inappropriate management occurred in 85.8% of hyperglycemic patients versus 11.1% of euglycemic patients (adjusted OR 80.59, 95% CI not provided, p < 0.001).
Routine HbA1c testing identified occult diabetes in 18.4% of patients without prior diagnosis.
No severe hypoglycemia occurred.
Interpretation:
Admission hyperglycemia significantly increased the odds of unfavorable discharge outcomes and highlighted issues in glycemic management adherence.
Limitations:
Single-center study may limit generalizability.
Retrospective design may introduce bias.
Conclusion:
Structured admission orders, q6h monitoring, and routine HbA1c testing are immediate quality improvement targets for stroke services in the Gulf region.
