Highlights
- •Currently, one out of five patients with acute stroke will die during the initial hospitalization.
- •Traditional stroke risk factors are more frequent among diabetic patients.
- •Having a history of known diabetes mellitus is not associated with a higher in-hospital death rate after a stroke.
Abstract
Background
Estimates from developed countries show that early mortality after stroke is unaffected
by diabetes status. Despite the high burden of both conditions in sub-Saharan Africa,
data on the association between diabetes status and early mortality are lacking.
Objective
In a major referral hospital in the Capital city of Cameroon, among acute stroke patients
diagnosed using the World Health Organization criteria, we compared mortality rates
in patents with and without known diabetes.
Methods
Stroke patients with and without known diabetes were compared for demographic characteristics, risk factors, clinical, radiological,
laboratory characteristic, and in-hospital mortality. Heterogeneities in mortality
rates across major subgroups were investigated via interaction tests, and logistic
regression accelerated failure-time models used to adjust for confounders.
Results
Of the 1667 acute stroke patients included, 213 (12.8%) had diabetes mellitus. In
general diabetic patients were older (median age 64.0 vs. 62.0 years, p = 0.0006), and were more likely to have other stroke risk factors including a higher
triglyceride levels on admission (106 vs. 97 mg/dL, p = 0.044), a history of stroke (19.7% vs. 13.6%, p = 0.022), and a history of hypertension (89.7% vs. 64.8%, p < 0.0001). The death rates of diabetic patients and that of non-diabetic patients were
similar (22.1% vs. 20.1%. p = 0.524). This finding was similar across all pre-specified groups, with no evidence
of interaction. Diabetes was unrelated with mortality in adjusted regression models.
Conclusion
Diabetes is frequent among stroke patients in this setting, and often co-exists with
other stroke risk factors. In-hospital mortality rate is equally high in diabetic
and non-diabetic patients.
Keywords
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Article info
Publication history
Published online: July 31, 2016
Accepted:
July 16,
2016
Received in revised form:
May 26,
2016
Received:
January 8,
2016
Identification
Copyright
© 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
