Abstract Details

Title Discharge Outcomes of Ischemic Stroke Patients with Diabetes: Get with the Guidelines

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 250

Objective

Background BACKGROUND: Diabetes is a major risk factor for IS. Patients with DM have more severe strokes and higher mortality than non-diabetics. It is unclear if DM impacts discharge disposition and ambulatory status after stroke. We describe our experience in an inner city hospital using the Get-With-The-Guidelines-Stroke database.

Design/Methods DESIGN/METHODS: We retrospectively reviewed all cases of IS admitted to Boston Medical Center from January/08 - June/12. DM was defined as history of DM, prior use of diabetes medication, or HbA1c ?6.5. Using t-test and Fisher exact test of significance we compared baseline social, clinical, ambulatory status at discharge, and discharge disposition characteristics between DM and non-DM patients. Discharge ambulatory status was categorized as independent or use of minimal assistance vs. unable to ambulate; and discharge disposition as home, inpatient rehab, skilled nursing facility, long term care, hospice, or expired.

Results RESULTS: A total of 1031 IS patients were identified, of which 53% were diabetic. Mean age was 65 and 51.5% were male. Of all, 50.7% were Black, 33.2% White, 2% Asian, 0.3% Native-American, 3.8% other and 10% undetermined. DM was more prevalent in Blacks (p<0.001). NIHSS on admission was similar for both groups (6.19 for DM vs. 6.20). DM patients had higher SBP (p=0.01), creatinine (p=0.005), and BMI (p<0.001). DM patients were more often discharged to hospice (p<0.06), while disposition to other facilities was similar. Patients with DM (47.2% of 549) were more often non-ambulatory at discharge (p<0.0001).

Conclusions CONCLUSIONS: Our data suggest DM may impact ambulatory status at discharge. While limited by less objective evaluations of stroke severity, the impact of DM on discharge disposition of IS patients warrants further study.

Authors/Disclosures
Rony N. Salem, MD PRESENTER	No disclosure on file
Aleksandra Pikula, MD	The institution of Dr. Pikula has received research support from CIHR.
Helena W. Lau	No disclosure on file
Thanh Nguyen, MD	Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vesalio. Dr. Nguyen has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avania. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. The institution of Dr. Nguyen has received research support from Boston Medical Center. The institution of Dr. Nguyen has received research support from Society of Vascular and Interventional Neurology.
Ashkan Shoamanesh, MD	Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada .
Carlos S. Kase, MD, FAHA, FAAN	Dr. Kase has nothing to disclose.
Viken L. Babikian, MD, FAAN	Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Baim Institute for Clinical Research. Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific.
Jose R. Romero, MD (Boston University School of Medicine - Boston Medical Center)	The institution of Dr. Romero has received research support from NIH/NIA.
Diego Centonze	Diego Centonze has nothing to disclose.

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