{
  "abstract": "Background Clinical evidence of the potential influence of stress hyperglycemia ratio (SHR) for patients with large ischemic stroke whether or not receiving endovascular therapy is not clear.Methods This study was a subanalysis of a prospective, multicenter registry, and included 745 patients with large ischemic stroke across 38 centers in China. A total of 427 patients were included in this study, with 285 received endovascular therapy (EVT) and 142 received standard medical therapy (SMT). SHR was defined as glucose (mmol/L)/(1.59 × HbA1C)–2.59. The primary outcome was a moderate neurological outcome (modified Rankin Scale (mRS) score ≤3) at 90 days.Results A significant interaction was observed between SHR and whether received EVT (p=0.017). Among patients who received EVT (adjusted OR (aOR) 0.46; 95% CI 0.23 to 0.92; p=0.029), patients in the highest tertile of SHR were significantly less likely to achieve a moderate neurological outcome at 90 days compared with those in the lowest tertile. However, this association was not observed in patients receiving SMT (aOR 2.46; 95% CI 0.74 to 8.21; p=0.142). EVT patients with higher SHR had a significantly higher incidence of symptomatic intracranial hemorrhage compared with lower SHR (aOR 3.29; 95% CI 1.08 to 10.06; p=0.036), while such an association was not observed in the SMT group (aOR 1.52; 95% CI 0.56 to 4.12; p=0.410).Conclusions In patients with large ischemic stroke treated with EVT, SHR is associated with a reduced likelihood of achieving a moderate neurological outcome, as well as an increased risk of symptomatic intracranial hemorrhage.Trial registration number ChiCTR2100051664.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Xiaolei Shi"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Shihai Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Changwei Guo"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Wenzhe Sun"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Jiaxing Song"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Shitao Fan"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Jie Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Chengsong Yue"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Jiandi Huang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Linyu Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Yan Tian"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Jinfu Ma"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Xu Xu"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Zhixi Wang"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Weilin Kong"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Dongsheng Ye"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Zhouzhou Peng"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Fengli Li"
    },
    {
      "affiliations": [
        "Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China"
      ],
      "name": "Wenjie Zi"
    }
  ],
  "title": "Impact of stress hyperglycemia on outcomes in patients with large ischemic stroke",
  "uid": "d7a1139c-5e16-54b2-ae8d-f8ca10bea411"
}