While past research has found a link between glycemic control and outcome after thrombectomy for ischemic stroke, these studies focused on glucose levels at presentation and did not control for other factors. There is still much to be learned about this relationship.

We analyzed the relationship between glycemic control and mortality prior to discharge in a cohort of patients who underwent thrombectomy for acute ischemic stroke at NYU Tisch and NYU Brooklyn campuses between December 2018 and November 2020.  Glycemic control was evaluated based on first glucose and both maximum and minimum glucose during the admission. All analyses were performed using Welch’s two sample t-test, chi-squared test, and logistic regression accounting for initial NIHSS and post-thrombectomy ASPECTS score, where OR is for each unit increase in the respective variables.

Of 254 patients, 42 (16.5%) died prior to discharge. Mortality was significantly associated with higher maximum glucose over the entire admission (245 ± 89 mg/dL vs 185 ± 78 mg/dL, p < 0.001). However, first glucose measurement and minimum glucose over the entire admission were not significantly associated with mortality. There was a non-significant trend towards increased risk of mortality for patients with an established diagnosis of diabetes before admission (40.5% vs 25.5%, p = 0.073). On multivariate analysis, there was a significant relationship between mortality and maximum glucose during the admission (OR per mg/dL of glucose = 1.007, 95% CI 1.003-1.012, p < 0.001), initial NIHSS (OR = 1.10, 95% CI 1.05-1.16, p < 0.001) and post-thrombectomy ASPECTS score (OR = 0.84, 0.74-0.96, p < 0.01).