Original Article

THE RELATIONSHIP BETWEEN ON ADMISSION BLOOD GLUCOSE, INSULIN, C PEPTIDE, ACTH, CORTISOLE, AND DIHYDROEPIANDRESTERONE SULPHATE LEVEL AND PROGNOSIS ‹N ACUTE ISCHEMIC AND HEMORRHAGIC STROKE PATIENTS

  • A. Bayır
  • A. Ak
  • Ş.K Köstekçi
  • Ş. Özdinç
  • A. Seydanoğlu
  • B. Cander
  • F. Kara

Received Date: 11.02.2008 Accepted Date: 03.07.2008 Eurasian J Emerg Med 2008;7(4):31-35

Aim:

The aim of this study to investigate the relationship between blood glucose, insuline, C peptide, Adrenocorticotrophic Hormone (ACTH), cortisol, and Dihydroepiandrosterone sulphate (DHEASO4) level measured on admission both hospital mortality and Glascow Coma Score (GCS) in ischemic and hemorrhagic stroke patients, and to determine whether difference between ischemic and hemorrhagic stroke in point of this relationship.

Methods:

Those patients who experienced ischemic and hemorrhagic stroke and who applied to the hospital within the first 3 hours after the beginning of the symptoms were included in the study. On arrival GCS was detected. It was determined blood glucose, insulin, C peptide, ACTH, cortisol, and DHEASO4 levels each patients. The patients were allocated as ischemic and hemorrhagic stroke groups on admission. In addition, ischemic and hemorrhagic stroke groups were allocated as GCS ≤ 8 and GCS ≥ 9 groups. The patients were observed in terms of mortality during their stay in the hospital.

Results:

It was found significant reverse relationship between GCS and blood glucose level in all of groups (p=0.00). It was significant reverse relationship between GCS and mean blood glucose level on admission of dead patients (p=0.00). It was determined a significant reverse relationship between mean blood glucose level on admission and GCS in GCS ≤ 8 ischemic and hemorrhagic stroke groups. It was found significant revers relationship between GCS and mean ACTH level on admission in GCS ≤ 8 hemorrhagic stroke group (p=0.00). It was’nt found significant relationship between GCS and insülin, C peptide, and cortisol level on admission in not any groups.

Conclusion:

In patients with stroke who referred to the emergency clinic within the first 3 hours after the stroke developed, measured high glucose level on admission, could be indicator of bad prognosis and high hospital mortality. The high blood ACTH levels on admission in patients with hemorrhagic stroke in hyper acute periode may indicate bad prognosis and high hospital mortality.

Keywords: Stroke, prognosis, hyperglycemia, insulin, C peptide, ACTH, cortisol, DHEASO4