Which Glucose Parameter Best Predicts Poor Outcome after Mechanical Thrombectomy for Acute Large Vessel Occlusion Stroke

BACKGROUND Hyperglycemia is related to adverse outcomes in patients with acute ischemic stroke treated by mechanical thrombectomy (MT). AIM To compare the predictive ability of admission blood glucose (ABG), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) in patients with acute large vessel occlusion (ALVO) stroke undergoing MT. METHODS The study retrospectively analyzed the data of 329 consecutive acute stroke patients treated by MT. Multivariate logistic regression analysis was performed to investigate the predictors of poor functional outcome. Receiver operating characteristic (ROC) analysis was performed to identify the predictive ability of ABG, FBG, and HbA1c for poor functional independence in patients with ALVO stroke undergoing MT. In addition, subgroup analyses were performed for both diabetic and nondiabetic patients. RESULTS Multiple logistic regression analysis demonstrated that ABG and FBG were independent predictors of 3-month poor functional outcome; however, HbA1c could not predict poor functional outcome. Receiver operating characteristic (ROC) analysis showed that FBG has a higher predictive ability than ABG (areas under the ROC curve [AUCs]: 0.689 vs. 0.624, P = 0.037) and HbA1c (AUCs: 0.689 vs. 0.541, P<0.001) for poor function outcome. CONCLUSIONS ABG and FBG are independent predictors of poor functional outcome in patients with acute ischemic stroke undergoing MT, and FBG has a higher predictive ability than ABG and HbA1c. This article is protected by copyright. All rights reserved.