The impact of predisposing factors on long-term outcome after stroke in diabetic patients: The Fukuoka Stroke Registry

Background and purpose: Although stroke patients with diabetes mellitus have a poor prognosis, the prognostic factors of patients with diabetes mellitus have not been adequately studied. The aim of this study was to determine the predisposing factors for outcome 1year after stroke in diabetic patients. Methods: Patients' characteristics, findings on admission and outcome 1year after first ischaemic stroke were prospectively investigated in 452 consecutive patients with diabetes mellitus (305 males, 147 females; 69±10years old). A poor outcome was defined as a modified Rankin Scale (mRS) score ≥2, 1year after stroke onset. Results: There were 286 patients with a good outcome (mRS score ≤1) and 166 with a poor outcome (mRS score ≥2). On multivariate logistic regression analysis, age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03-1.10, P<0.001, per 1-year increase], National Institutes of Health Stroke Scale (NIHSS) score on admission (OR 1.21, 95% CI 1.11-1.32, P<0.001, per 1-point increase), diabetic nephropathy (OR 1.93, 95% CI 1.02-3.65, P=0.044) and hemoglobin A1c (HbA1c; OR 1.27, 95% CI 1.07-1.51, P=0.007, per 1% increase) were independently related to poor outcome (mRS score ≥2) 1year after the onset of the first stroke in diabetic patients. Conclusions: In stroke patients with diabetes mellitus, age, NIHSS score on admission, diabetic nephropathy and HbA1c were independently associated with a poor outcome 1year after the first ischaemic stroke.