Relationship between serum glucose-potassium ratio and 90-day outcomes of patients with acute ischemic stroke

Background: Recent studies have shown that the serum glucose-potassium ratio (GPR) upon admission is correlated with the prognosis of cerebrovascular disorders. Herein, we investigated the relationship between GPR and 90-day functional outcomes in patients with acute ischaemic stroke (AIS). Methods: Clinical data were collected from patients with AIS registered at the Stroke Center of Jiangsu Provincial Hospital of Chinese Medicine. The relationship between the GPR and 90-day outcomes was analysed using univariate and multivariate logistic regression analyses, linear regression analyses, and subgroup analyses. Results: A total of 1826 patients met the enrolment requirements. The number of patients with a glucose-to-potassium ratio greater than the median value increased proportionally with increases in the NIHSS at admission and the 90-day modified Rankin scale (mRS). Univariate logistic regression analysis revealed a significant relationship between GPR and 90-day negative prognosis (OR 1.34 [95%Cl, 1.17-1.54], P < 0.001). After adjusting for all confounding variables, the relationship between GPR and 90-day adverse prognosis was shown to be nonlinearly U-shaped, with an inflection point of the curve for GPR of 1.347. Two linear regression analyses were performed on the basis of the inflection points of the curves. The results of this analysis revealed a negative correlation between GPR and 90-day adverse outcomes at GPR<1.347 (OR 0.86 [95% CI,0.09-7.86], P = 0.897), as well as a positive correlation between GPR and 90-day adverse outcomes at GPR >= 1.347 >= 1.347 (OR1.52 [95%CI, 1.19-1.93], P = 0.001). Subgroup analyses verified that the association between GPR and 90-day poor prognosis still existed, regardless of whether the patient had a history of diabetes mellitus (DM). (with DM: OR 1.39 [ 95%Cl, 1.05-1.83], P = 0.001); without DM: OR 0.93 [ 95%Cl,0.56-1.55], P = 0.016). Conclusions: GPR significantly correlated with poor prognosis at 90-days in patients with AIS. Early intervention and control of GPR are expected to enhance functional outcomes in patients with AIS.