الفهرس 
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Abstract
Hyperglycemia is encountered in 20% to 40% of acute stroke patients, with or without a pre-morbid diagnosis of diabetes mellitus. Hyperglycemia is a risk factor for infarct expansion and poor outcome through the first 72 hours of hospitalization in both diabetics and nondiabetics.
Major and minor studies of stroke patients suggested that ‘Stress Hyperglycemia’ (raised blood glucose levels without a previous diagnosis of diabetes) was associated with a poorer outcome.
This study was a prospective cohort study conducted in Ain shams University Hospitals during the period from October 2019 to March 2020.
The aim of this work was to study the glycemic status after acute ischemic stroke and to assess the role of glycemic status in influencing the stroke outcome.
The study included a total of 105 patients presented with acute ischemic stroke within 24 hours from onset of symptoms. The study population were predominantly males (60.95%), with a mean age of 61.66 ± 10.38 years (range from 40 to 85 years).
The study population was divided into two groups according to the admission glycemic status; group I (35 patients as a control group) and group II (70 patients with hyperglycemia).
Patients of group II were further divided into two subgroups; subgroup A (35 patients with hyperglycemia and diabetes mellitus) and subgroup B (35 patients with stress hyperglycemia).
Demographic, clinical, and laboratory variables were recorded. The stroke severity was assessed by national institute of health stroke scale (NIHSS).
Our study revealed that:
• Hyperglycemia is a good predictor of mortality outcome after acute ischemic stroke (65.7% vs. 5.7%).
• Stress hyperglycemia had the worst mortality outcome compared with diabetic group and control group (85.7% vs. 45.7% vs. 5.7%; respectively).
• Hyperglycemia is a good marker of stroke severity assessed by NIHSS score (14.60 ± 5.80 vs. 7.60 ± 3.38).
• Hyperglycemia has significant association with longer ICU and hospital stay (12.26 ± 8.92 vs. 2.89 ± 4.07 days).
• NIHSS score is a significant predictor of mortality outcome after acute stroke (18.20 ± 3.43 vs. 7.30 ± 1.86).
• Hyperglycemia has significant association with posterior circulation strokes (20% vs. 0.0%).
• Patients with hyperglycemia had higher incidence of intracerebral complications, namely hemorrhagic transformation (17.1%) and brain edema (10%).