Abstract WP119: Admission Glycemic Gap In The Assessment Of Patients With Ischemic Stroke

Background: Admission glycemic gap (AGG) is derived by using HbA1c levels to establish a baseline which is compared to admission glucose (AG) levels. High AGG has been correlated with increased post-stroke cognitive impairment and a worse modified Rankin scale. Our aim is to evaluate the association of AGG with poor outcomes. Methods: Stroke patients admitted to tertiary academic hospital between 2016-2020 were tested for AGG using the formula AG - (28.7xHb1Ac-46.7). AGG was dichotomized as high (>80) AGG (H-AGG) and low (=/<80) AGG (L-AGG). Poor outcomes were defined as in-hospital mortality or poor discharge destination (in hospital mortality, discharge to long term care, skilled nursing home, and hospice). We also looked at the necessity for tracheostomy, PEG, and mechanical ventilation. The Pearson chi-square test was used to test for significance. A binary logistic regression was used to verify the association. The statistical analysis was performed using SPSS. Results: Of 594 patients (mean age 67, 44% female), 30 had an elevated AGG (5.1%). 33 (5.6%) had tracheostomy. 7 had (1.2%) PEG. 32 (5.4%) required mechanical ventilation. 242 patients (40.1%) had a bad outcome of which 74 (12.5% of the total) died. The age of the H-AGG and L-AGG groups was comparable, as verified by an independent sample test. The H-AGG group was associated with hospital mortality (p < .001) and poor discharge destination (p < .001) The association between AGG and both mortality and poor outcome was lost when adjusted for age. The elevated AGG was not associated with PEG(p=.69), tracheostomy(p=.5), and mechanical ventilation(p=.49). Discussion: An elevated AGG was found to be associated with hospital mortality and poor discharge destination on univariate analysis, while there was no association with a tracheostomy, PEG and need for mechanical ventilation. The association was lost when adjusted for the patient's age