Systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke

Authors

  • Elizabeth A. Laird MSc RN,

    Lecturer of Nursing, Associate Member of the Institute of Nursing Research, Corresponding author
    • School of Nursing, University of Ulster, Londonderry, UK
    Search for more papers by this author
  • Vivien Coates MPhil PhD RN,

    Professor Nursing Research
    1. Joint Appointment University of Ulster & Western Health and Social Care Trust, School of Nursing, Institute of Nursing Research, University of Ulster, Coleraine, UK
    Search for more papers by this author
  • David Chaney MSc PhD RN

    Lecturer of Nursing, Associate Member of the Institute of Nursing Research
    1. School of Nursing, University of Ulster, Londonderry, UK
    Search for more papers by this author

Correspondence to E.A. Laird: e-mail: ea.mitchell@ulster.ac.uk

Abstract

Aim

This article presents the results of a systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke.

Background

Hyperglycaemia is common among adults admitted to hospital with stroke.

Design

Systematic review.

Data sources

A search for descriptive cohort studies published between January 1996–June 2011, was conducted in MEDLINE, PubMed and Embase electronic databases. The search was performed using the terms ‘stroke’, ‘hyperglycaemia’ and/or ‘glucose’ combined and limited to adults and English language publications. Searching of citations from identified studies supplemented the electronic searches.

Review methods

A systematic review was conducted of eight studies, meeting the criteria of: (1) descriptive cohort studies; (2) adults admitted to hospital with acute stroke; and (3) glycaemic status monitored over at least two consecutive days from admission to hospital. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis standards.

Results

The dynamics of glycaemia after stroke has been investigated in seven prospective cohort studies and one retrospective study. The patterns that emerged were persisting normoglycaemia, transient hyperglycaemia, persisting hyperglycaemia and delayed hyperglycaemia. Surges in glycaemia are likely on days 2 and 3 and some adults will not exhibit hyperglycaemia till day 7.

Conclusion

Further large cohort studies are required to explore the dynamic of glycaemia after stroke for at least 1 week duration. The timing of formal screening for diabetes mellitus is important, as early screening may overestimate detection rates.

Ancillary