Clinical Outcomes and Costs of Recurrent Ischemic Stroke: A Systematic Review

Ferrone, Sophia R; Boltyenkov, Artem; Lodato, Zachary; O'Hara, Joseph; Vialet, Jaclyn; Malhotra, Ajay; Katz, Jeffrey M.; Wang, Jason J; Feizullayeva, Chinara; Sanelli, Pina C.

doi:10.1016/j.jstrokecerebrovasdis.2022.106438

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Furthermore, patients with a prior history of IS with high National Institutes of Health Stroke Scale (NIHSS) and high Modified Rankin Scale (mRS) scores are at an increased risk of the recurrence [14]. Recurrent IS also worsens functional outcomes, increases disability and institutionalization, and raises in-hospital costs and mortality rates [16][17][18][19]. Therefore, it is important for healthcare providers to identify early those patients who are at high risk of developing recurrent IS.…”

Section: Introductionmentioning

confidence: 99%

Incidence of recurrent ischemic stroke and its associated factors in a tertiary care center in Thailand: a retrospective cohort study

Taweephol,

Saksit,

Hiransuthikul

et al. 2024

BMC Neurol

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Background Ischemic stroke (IS) is one of the leading causes of death among non-communicable diseases in Thailand. Patients who have survived an IS are at an increased risk of developing recurrent IS, which can result in worse outcomes and post-stroke complications. Objectives The study aimed to investigate the incidence of recurrent IS among patients with first-ever IS during a one-year follow-up period and to determine its associated risk factors. Methods Adult patients (aged ≥ 18 years) who were hospitalized at the Stroke Center, King Chulalongkorn Memorial Hospital (KCMH) in Bangkok, Thailand, due to first-ever IS between January and December 2019 and had at least one follow-up visit during the one-year follow-up period were included in this retrospective cohort study. IS diagnosis was confirmed by neurologists and imaging. The log-rank test was used to determine the event-free survival probabilities of recurrent IS in each risk factor. Results Of 418 patients hospitalized due to first-ever IS in 2019, 366 (87.6%) were included in the analysis. During a total of 327.2 person-years of follow-up, 25 (6.8%) patients developed recurrent IS, accounting for an incidence rate of 7.7 per 100 person-year (95% confidence interval [CI] 5.2–11.3). The median (interquartile range) time of recurrence was 35 (16–73) days. None of the 47 patients with atrial fibrillation developed recurrent IS. The highest incidence rate of recurrent IS occurred within 1 month after the first episode (34 per 100 person-years) compared to other follow-up periods. Patients with small vessel occlusion and large-artery atherosclerosis (LAA) constituted the majority of patients in the recurrent IS episode (48% and 40%, respectively), with LAA exhibiting a higher recurrence rate (13.5%). Additionally, smoking status was found to be associated with an increased risk of recurrence. Conclusion The incidence rate of the recurrence was moderate in our tertiary care setting, with a decreasing trend over time after the first episode. The various subtypes of IS and smoking status can lead to differences in event-free survival probabilities.

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Section: Introductionmentioning

confidence: 99%

Incidence of recurrent ischemic stroke and its associated factors in a tertiary care center in Thailand: a retrospective cohort study

Taweephol,

Saksit,

Hiransuthikul

et al. 2024

BMC Neurol

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Economic Evaluation of an Enhanced Post-Discharge Home-Based Care Program for Stroke Survivors

Wong,

Wang,

et al. 2024

Value in Health

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Recurrent Ischemic Stroke and Transient Ischemic Attack: Risk of Single and Multiple Recurrence

Park,

Lee,

Jung

2024

JCM

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Background/Objectives: Efforts have been made toward primary or secondary stroke or transient ischemic attack (TIA) prevention. However, little attention has been paid to recurrent stroke or TIA. This study investigated risk factors for multiple or single recurrent stroke or TIA. Methods: Data from 3646 patients with ischemic stroke or TIA were obtained from the Korea University Ansan Hospital Stroke Center between March 2014 and December 2021, using the prospective institutional database of the Korea University Stroke Registry. The associations between clinical features and recurrent stroke or TIA were assessed using bivariable and multivariable Cox models. Results: Recurrent stroke or TIA was associated with male sex (adjusted hazard ratio (HR) 1.95, 95% confidence interval (CI) 1.42–2.80), hypertension (HR 1.49, 95% CI 1.00–2.23), diabetes mellitus (HR 1.54, 95% CI 1.13–2.13), an etiologic subtype of transient ischemic attack (HR 1.88, 95% CI 1.09–3.16), white matter changes (HR 1.62, 95% CI 1.05–2.38), and cerebral microbleeds (HR 1.79, 95% CI 1.26–2.59). Multiple recurrent stroke or TIA was associated with male sex (HR 3.86, 95% CI 1.94–11.55), diabetes mellitus (HR 2.40, 95% CI 1.31–4.53), and anemia (HR 4,58, 95% CI 2.31–10.44). Conclusions: Given the risk factor profiles for recurrent stroke or TIA, risks differed among patient subgroups and were based on multiple or single recurrences. It may exert an effect as a prognostic indicator in the high risk of recurrences.

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Clinical Outcomes and Costs of Recurrent Ischemic Stroke: A Systematic Review

Cited by 3 publications

References 22 publications

Incidence of recurrent ischemic stroke and its associated factors in a tertiary care center in Thailand: a retrospective cohort study

Incidence of recurrent ischemic stroke and its associated factors in a tertiary care center in Thailand: a retrospective cohort study

Economic Evaluation of an Enhanced Post-Discharge Home-Based Care Program for Stroke Survivors

Recurrent Ischemic Stroke and Transient Ischemic Attack: Risk of Single and Multiple Recurrence

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