Mapoure Yacouba Njankouo, Ba Hamadou, Ayeah Chia Mark, Kenmegne Caroline, Luma Henry Namme, Njamnshi Alfred Kongnyu
Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala General Hospital, Douala, Cameroon.
Department of Internal Medicine, University of Yaoundé I, Yaoundé Central Hospital, Yaoundé, Cameroon.
J Stroke Cerebrovasc Dis. 2018 Sep;27(9):2327-2335. doi: 10.1016/j.jstrokecerebrovasdis.2018.04.017. Epub 2018 May 18.
Diabetes mellitus (DM) is associated with poor outcomes in acute stroke patients (ASPs). This study aims to determine the prevalence of NDDM in the ASPs and to compare the outcome in NDDM and previously diagnosed DM (PDDM) in Cameroon.
This was a hospital-based prospective cohort study that included ASPs with NDDM and PDDM. Outcome data were collected within 3 months of stroke onset. Chi-square and t tests were used for comparisons, whereas survival analysis was performed using Cox regression and Kaplan-Meier analysis.
Of the 701 ASPs included, 24.8% had PDDM (n = 174) and 9.4% NDDM (n = 66). NDDM had a higher mortality rate on admission and 3 months after stroke (P < .05). PDDM were more likely to survive within 3 months after stroke onset (log-rank test P = .008). The risk of dying among NDDM was increased (adjusted hazard ratio = 1.809; 95% confidence interval: 1.1532.839; P = .010). NDDM were more likely to have higher mean National Institutes of Health Stroke Scale and modified Rankin score (P < .05) on admission. PDDM were more likely to develop urinary tract infections during hospitalization (P = .015). There was no significant difference between functional outcome on admission and 3 months after stroke (P > .05).
NDDM are associated with increased mortality and are more likely to have poorer functional outcomes and more severe stroke than those with PDDM.
糖尿病（DM）与急性卒中患者（ASP）的不良预后相关。本研究旨在确定喀麦隆急性卒中患者中未诊断糖尿病（NDDM）的患病率，并比较NDDM和既往诊断糖尿病（PDDM）患者的预后。
这是一项基于医院的前瞻性队列研究，纳入了患有NDDM和PDDM的急性卒中患者。在卒中发作后3个月内收集结局数据。采用卡方检验和t检验进行比较，生存分析采用Cox回归和Kaplan-Meier分析。
在纳入的701例急性卒中患者中，24.8%患有PDDM（n = 174），9.4%患有NDDM（n = 66）。NDDM患者入院时和卒中后3个月的死亡率更高（P < 0.05）。PDDM患者在卒中发作后3个月内更有可能存活（对数秩检验P = 0.008）。NDDM患者死亡风险增加（调整后的风险比 = 1.809；95%置信区间：1.153 - 2.839；P = 0.010）。NDDM患者入院时更有可能具有更高的平均国立卫生研究院卒中量表评分和改良Rankin评分（P < 0.05）。PDDM患者在住院期间更有可能发生尿路感染（P = 0.015）。入院时和卒中后3个月的功能结局之间无显著差异（P > 0.05）。
与PDDM患者相比，NDDM患者死亡率增加，功能结局更差，卒中更严重。
