459-P: Association of Intraoperative Mean Glucose with Clinical Outcomes in Patients with Acute Ischemic Stroke Treated by Mechanical Thrombectomy

Introduction & Objective: Poststroke hyperglycemia is common and associated with adverse outcomes for patients with acute ischemic stroke (AIS). However, the evidence of glucose level during mechanical thrombectomy (MT) are limited. This study aimed to investigate the association between intraoperative glucose level based on continuous glucose monitoring (CGM) system and clinical outcomes.

Method: In this single-center, retrospective and observational study, we consecutively included AIS patients treated by MT within 24 hours from symptom onset. All subjects received a CGM system iPro2^® when they arrived at the interventional room. Clinical outcomes included in-hospital mortality, in-hospital neurological improvement and deterioration, 3-month function independence and mortality. Logistic regression estimated the association between intraoperative mean glucose and outcomes.

Results: A total of 123 AIS patients [women: 50 (40.65%), median age: 71 (60-78), diabetes: 25 (20.33%)] were included. During MT therapy, the median period of glucose monitoring was 1.04 hours, and the median mean glucose level was 6.87 mmol/L. Mean glucose was independently related to in-hospital mortality (OR 1.539, 95% CI 1.078-2.315, p = 0.026), 3-month mortality (OR 1.418, 95% CI 1.019-2.048, p = 0.048) and functional independence (OR 0.695, 95% CI 0.493-0.931, p = 0.023) after adjusting for potential confounders. There was no association of intraoperative mean glucose with in-hospital neurological improvement (OR 0.876, 95% CI 0.695-1.090, p = 0.242) and neurological deterioration (OR 1.159, 95% CI 0.909-1.499, p = 0.244).

Conclusion: Among AIS patients who received MT treatment, intraoperative mean glucose was associated with in-hospital mortality, 3-month adverse neurological function and mortality.