Effect of intensive insulin treatment on healthcareassociated infection rate in acute stroke: A Metaanalysis

Abstract:

ObjectiveTo evaluate effect of intensive insulin treatment(IIT) on healthcareassociated infection (HAI) rate in patients with acute stroke and stress hyperglycemia.MethodsDatabases, including PubMed, Embase, Cochrane Library, WanFang, and China National Knowledge Infrastructure（CNKI） Data, were electronically searched, relevant journals and references of the included literatures were also searched manually, literatures were selected according to the uniform inclusion and exclusion criteria, incidence of HAI and mean blood glucose in patients who received IIT for acute stroke were assessed systematically.ResultsA total of 13 randomized controlled trials (RCT) involving 1 032 patients were included in this systematic review. Metaanalysis results showed that 10 studies involving 832 patients were finally enrolled for comparing HAI rate, HAI rates in IIT group and conventional insulin treatment group were 28.3% and 56.1%， respectively(Z=4.50)， difference between two groups was statistically significant  (RR=0.53 ［95 %CI: 0.40 to 0.70］, P＜0.001)； A total of 328 patients in 5 studies were finally included in the comparison of blood glucose, difference in mean blood glucose between two groups was statistically significant( MD=-2.52 ［95% CI: -4.30 to -0.74］, P=0.006). Funnel plot of HAI rate revealed that there was publication bias.ConclusionIIT is used for the regulation of stress hyperglycemia in acute stroke, it can reduce the incidence of HAI and blood glucose in patients.