The impact of predisposing factors on long-term outcome after stroke in diabetic patients: the Fukuoka Stroke Registry
Article first published online: 9 FEB 2013
© 2013 The Author(s) European Journal of Neurology © 2013 EFNS
European Journal of Neurology
Volume 20, Issue 6, pages 921–927, June 2013
How to Cite
Kuwashiro, T., Sugimori, H., Ago, T., Kuroda, J., Kamouchi, M. and Kitazono, T. (2013), The impact of predisposing factors on long-term outcome after stroke in diabetic patients: the Fukuoka Stroke Registry. European Journal of Neurology, 20: 921–927. doi: 10.1111/ene.12100
- Issue published online: 12 MAY 2013
- Article first published online: 9 FEB 2013
- Manuscript Accepted: 12 DEC 2012
- Manuscript Received: 2 SEP 2012
- diabetes mellitus;
- diabetic nephropathy;
- hemoglobin A1c;
- ischaemic stroke;
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.
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.
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.
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.