Abstract WP201: Outcomes Of Ischemic And Hemorrhagic Stroke Patients With Cancer: Japan Stroke Data Bank

Abstract

Purpose: We aim to clarify the association between history of cancer with clinical outcomes after ischemic stroke (IS) or hemorrhagic stroke (HS). Methods: Study participants were adult patients within seven days after onset of IS or HS from the register of the Japan Stroke Data Bank, a hospital-based multicenter stroke registration database, between 2000 and 2021, whose modified Rankin Scale score at discharge was available. Participants were divided into three groups [active cancer (AC) group, inactive cancer (iAC) group, and without cancer group]. Outcomes including good functional outcome, representing modified Rankin Scale score 0-2 at discharge, and in-hospital death was compared between the groups using multivariate analysis by forward-backward stepwise selection method for stroke subtype. AC was defined as cancer diagnosed within six months, requiring chemotherapy or surgical treatment, metastatic, or inoperable. Results: Of 171292 stroke patients, including 128145 with IS and 43147 with HS, 1074 patients had AC (women 42.5%; median age, 77 years; median (interquartile range) baseline National Institutes of Health Stroke Scale 5 [2–15]; IS 84.3%), 6337 patients had iAC (37.9%; 73 years; 4 [2–13]; 79.5%), and 163881 patients did not have cancer (42.4%; 73years; 4 [2–12]; 74.6%). Good functional outcome after IS was less common in cancer patients [AC; 39.4%, adjusted odds ratio (OR) 0.78, 95% confidence interval (CI) 0.71-0.86: iAC; 49.1%, adjusted OR 0.92, 95% CI 0.85-0.99] than those without cancer (56.3%), and mortality in cancer patients was higher (AC; 10.6%, adjusted OR 1.77, 95% CI 1.56-2.01: iAC; 5.6%, adjusted OR 1.26, 95% CI 1.09-1.47) than those without cancer (4.4%). Good functional outcome after HS was less common in cancer patients [AC; 22.0%, adjusted OR 0.81, 95% CI 0.61-1.07: iAC; 24.6%, adjusted OR 0.78, 95% CI 0.64-0.94] than those without cancer (35.3%), and mortality after HS was higher in AC patients (29.8%) than those without cancer (15.9%, adjusted OR 1.61, 95% CI 1.26-2.07) Conclusions: IS patients with AC and those with iAC significantly had less achievement of good functional outcomes and more in-hospital death, and HS patients with AC led to more in-hospital death than patients without cancer.