Background Stroke in young people can lead to long-term disability and heavy social and family burden. Studies have shown that increased hypersensitivity C-reactive protein (hs-CRP) and stress blood glucose were associated with increased risk of ischemic stroke occurrence and its poor prognosis, but so far, there is still lack of research evidence in young patients with stroke.
Objective To explore the association of hs-CRP and random blood glucose with neurological impairment, long-term and short-term prognosis in young patients with stroke, respectively.
Methods Patients aged 18 to 45 years with first ever ischemic stroke, admitted within 72 hours of onset to the Department of Neurology, Beijing Tiantan Hospital Affiliated to Capital Medical University from 2019 to 2021 were retrospectively selected. Demographic information, risk factors, laboratory results and complications, etc. of the patients were collected. Patients were divided into 4 groups according to the quartile of hs-CRP: group Q1 (n=160) , group Q2 (n=156) , group Q3 (n=157) , group Q4 (n=157) ; patients were also divided into four groups according to the quartile of random blood glucose: group q1 (n=158) , group q2 (n=158) , group q3 (n=157) , group q4 (n=157) . The National Institutes of Health Stroke Scale (NIHSS) score>4 was used as the criterion of neurological deficit at discharge, the modified Rankin Scale (mRS) score of 2-5 was used as the criterion of poor short-term prognosis at discharge, and the mRS score of 2 to 5 at 90 d was used as the criterion of poor long-term prognosis. Logistic regression analysis was used to explore the association of hs-CRP and random blood glucose with neurological impairment, poor short-term and long-term prognosis.
Results Among 630 patients, 154 (24.4%) patients suffered neurological impairment, 217 (34.4%) patients had poor short-term prognosis, and 144 (22.9%) patients had poor long-term prognosis. Multiple Logistic regression analysis showed that compared with group Q1, the risks of neurological impairment〔OR=2.86, 95%CI (1.56, 5.22) ; OR=2.99, 95%CI (1.63, 5.50) 〕, poor short-term prognosis〔OR=2.14, 95%CI (1.25, 3.66) ; OR=2.80, 95%CI (1.62, 4.83) 〕and poor long-term prognosis〔OR=3.17, 95%CI (1.67, 6.01) ; OR=3.61, 95%CI (1.90, 6.86) 〕 were all increased in groups Q3 and Q4. Logistic regression analysis also showed that compared with group q1, the risk of poor long-term prognosis in group q3 was increased〔OR=1.94, 95%CI (1.07, 3.53) 〕, and the risks of poor short-term prognosis〔OR=2.05, 95%CI (1.11, 3.82) 〕and poor long-term prognosis〔OR=2.62, 95%CI (1.31, 5.24) 〕 in group q4 were also increased (P<0.05) . And consistent results were still obtained after further excluding patients with pneumonia, urinary infection and infectious diarrhea.
Conclusion hs-CRP>1.18 mg/L is a risk factor for poor long-term and short-term prognosis and neurological impairment at discharge in young patients with stroke. Random blood glucose>5.56 mmol/L is associated with poor long-term prognosis, while random blood glucose>7.01 mmol/L is associated with poor short-term prognosis, but not with neurological impairment at discharge in young patients with stroke.
