The impact of predisposing factors on long-term outcome after stroke in diabetic patients: the Fukuoka Stroke Registry.

BACKGROUND AND PURPOSE

Although stroke patients with diabetes mellitus have a poor prognosis, the prognostic factors of patients with diabetes mellitus have not been adequately studied. The aim of this study was to determine the predisposing factors for outcome 1 year after stroke in diabetic patients.

METHODS

Patients' characteristics, findings on admission and outcome 1 year after first ischaemic stroke were prospectively investigated in 452 consecutive patients with diabetes mellitus (305 males, 147 females; 69 ± 10 years old). A poor outcome was defined as a modified Rankin Scale (mRS) score ≥ 2, 1 year after stroke onset.

RESULTS

There were 286 patients with a good outcome (mRS score ≤ 1) and 166 with a poor outcome (mRS score ≥ 2). On multivariate logistic regression analysis, age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03-1.10, P < 0.001, per 1-year increase], National Institutes of Health Stroke Scale (NIHSS) score on admission (OR 1.21, 95% CI 1.11-1.32, P < 0.001, per 1-point increase), diabetic nephropathy (OR 1.93, 95% CI 1.02-3.65, P = 0.044) and hemoglobin A1c (HbA1c; OR 1.27, 95% CI 1.07-1.51, P = 0.007, per 1% increase) were independently related to poor outcome (mRS score ≥ 2) 1 year after the onset of the first stroke in diabetic patients.

CONCLUSIONS

In stroke patients with diabetes mellitus, age, NIHSS score on admission, diabetic nephropathy and HbA1c were independently associated with a poor outcome 1 year after the first ischaemic stroke.