Supplementary Material for: Association of Admission Hyperglycemia with Clinical Outcomes in Japanese Patients with Acute Large Vessel Occlusion Stroke: A post hoc Analysis of the Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism Japan Registry 2

<b><i>Introduction:</i></b> Admission hyperglycemia is an indicator of poor functional prognosis in acute stroke, but investigations of its prevalence and effects on the outcomes of acute large vessel occlusion in real-world, large-scale studies are limited, especially in Asian population. <b><i>Objective:</i></b> We aimed to elucidate the relationship between admission hyperglycemia and outcomes in a prospective multicenter registry in Japan. <b><i>Methods:</i></b> We analyzed data from the Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism (RESCUE) Japan Registry 2, which was a prospective, multicenter registry that enrolled patients from 46 centers in Japan. Admission hyperglycemia was defined as blood glucose level &gt;140 mg/dL. The relationships between clinical outcomes and admission hyperglycemia were analyzed in all 1,932 assessable patients. A favorable functional outcome, defined as a modified Rankin Scale score of 0–2 at day 90, as well as mortality within 90 days and symptomatic intracranial hemorrhage (SICH) within 72 h, was analyzed. We performed subgroup analyses of the adjusted variables to investigate the association between hyperglycemia and favorable outcome in relation to each variable. <b><i>Results:</i></b> Admission hyperglycemia was present in 687 (35.6%) of the assessable patients and in 420 (26.9%) of the 1,561 patients without diabetes. A favorable outcome was significantly less frequent in the hyperglycemia group than in the no-hyperglycemia group (33.2% vs. 47.6%, adjusted odds ratio [OR]: 0.60, 95% confidence interval [CI]: 0.47–0.76). The mortality rates were 12.8% and 6.8% in the hyperglycemia and no-hyperglycemia groups, respectively. The incidence of SICH within 72 h was higher in the hyperglycemia group than in the no-hyperglycemia group (4.4% vs. 1.9%, adjusted OR: 2.54, 95% CI: 1.36–4.82). Hyperglycemia was associated with unfavorable outcomes in almost all subgroups. <b><i>Conclusions:</i></b> Admission hyperglycemia in Japanese patients with large vessel occlusion stroke is associated with an unfavorable functional outcome at 90 days, mortality within 90 days, and the occurrence of SICH within 72 h.

<b><i>引言：</i></b> 入院高血糖是急性卒中功能预后不良的指征，但目前真实世界大规模研究中，探讨其患病率及对急性大血管闭塞卒中患者预后影响的相关研究较为有限，在亚洲人群中这一情况尤为突出。<b><i>研究目的：</i></b> 本研究旨在通过日本的一项前瞻性多中心注册研究，阐明入院高血糖与急性大血管闭塞卒中患者预后的关联。<b><i>研究方法：</i></b> 本研究分析了超急性脑栓塞血管内救治恢复（Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism，RESCUE）日本注册研究2的数据。该研究为前瞻性多中心注册研究，共纳入日本46家医学中心的受试患者。入院高血糖定义为血糖水平＞140 mg/dL。本研究对1932例可评估患者的临床结局与入院高血糖的关联进行了分析。所分析的临床结局包括：90天时改良Rankin量表（modified Rankin Scale, mRS）评分0~2分的良好功能预后、90天内全因死亡率，以及72小时内症状性颅内出血（symptomatic intracranial hemorrhage, SICH）的发生率。此外，本研究还针对校正变量开展亚组分析，以探讨各亚组中高血糖与良好功能预后的关联。<b><i>研究结果：</i></b> 可评估患者中共有687例（35.6%）存在入院高血糖；在1561例无糖尿病史的患者中，入院高血糖发生率为420例（26.9%）。高血糖组的良好功能预后发生率显著低于非高血糖组（33.2% vs. 47.6%，校正比值比[OR]=0.60，95%置信区间[CI]：0.47~0.76）。高血糖组与非高血糖组的90天死亡率分别为12.8%与6.8%。72小时内症状性颅内出血的发生率在高血糖组更高（4.4% vs. 1.9%，校正OR=2.54，95%CI：1.36~4.82）。几乎所有亚组中，高血糖均与不良功能预后显著相关。<b><i>研究结论：</i></b> 日本大血管闭塞卒中患者的入院高血糖与90天不良功能预后、90天内死亡率及72小时内症状性颅内出血的发生风险升高显著相关。