Stress hormone and blood glucose response following acute stroke in the elderly

We studied the relation of reactive hyperglycemia, stress hormone response, and outcome in 23 consecutive elderly patients (median age 80 [range 75-92] years) following an acute first stroke. The median delay from the onset of the stroke to the first blood sample (day 0) was 9 (range 4-22) hours. Su...

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Bibliographic Details
Published in:Stroke (1970) 1991-07, Vol.22 (7), p.842-847
Main Authors: O'NEILL, P. A, DAVIES, I, FULLERTON, K. J, BENNETT, D
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Aged, 80 and over
Biological and medical sciences
Blood Glucose - analysis
Cerebrovascular Disorders - blood
Cerebrovascular Disorders - mortality
Female
Glucagon - blood
Hormones - blood
Humans
Hydrocortisone - blood
Insulin - blood
Male
Medical sciences
Neurology
Osmolar Concentration
Prospective Studies
Regression Analysis
Stress, Physiological - blood
Survival Analysis
Vascular diseases and vascular malformations of the nervous system
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Summary:We studied the relation of reactive hyperglycemia, stress hormone response, and outcome in 23 consecutive elderly patients (median age 80 [range 75-92] years) following an acute first stroke. The median delay from the onset of the stroke to the first blood sample (day 0) was 9 (range 4-22) hours. Subsequent blood samples were taken, after fasting, for the determination of blood glucose, cortisol, catecholamine, insulin, C-peptide, glucagon, and lactate concentrations on days 1, 2, 3, 7, 14, 30, and 90. For all 23 patients, a significant relation was found between the blood glucose concentration and survival (p = 0.03) and the blood glucose concentration decreased with time (p less than 0.001). There was also a significant relation between blood glucose concentration and outcome (p = 0.02). For the 15 patients with complete data, the major determinants of the blood glucose concentration were the cortisol, insulin, and glucagon concentrations (all p less than 0.001), which accounted for 42% of the variance. When all the indexes were analyzed together by logistic regression, only the cortisol concentration was related to outcome (p = 0.02). Hyperglycemia following a stroke probably reflects the intensity of the stress hormone response. We have confirmed that hyperglycemia is a predictor of outcome in persons with stroke.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.22.7.842