Stroke outcome prediction: what do we know and where are we going?

In this issue of the European Journal of Neurology, the study by Dr. Zhang et al. explored the association between chronic hyperglycemia and either hemorrhagic transformation (HT) or short-term outcome in patients with acute anterior stroke [1]. In a cohort of 426 patients, they found that higher levels of glycosylated hemoglobin (HbA1c) measured in the morning after hospitalization were independently associated with an increased risk of HT, after the adjustment for the potential confounding effects of diabetes mellitus, admission and fasting blood glucose, thrombolytic treatment, stroke etiology, infarct volume and neurological deficit. Similarly, the suboptimal pre-stroke glycemic status was an independent predictor of poor functional outcome at hospital discharge, regardless of baseline glycemia, stroke severity and blood pressure levels. Noteworthy, HbA1c can reflect the long-term glycemic status without being influenced by stress-induced hyperglycemia, reinstitution of oral feeding, or administration of glucose-containing fluids [2]. This article is protected by copyright. All rights reserved.