Predicting Early Mortality of Acute Ischemic Stroke

Gattringer, Thomas; Posekany, Alexandra; Niederkorn, Kurt; Knoflach, Michael; Poltrum, Birgit; Mutzenbach, Sebastian; Haring, Hans‐Peter; Ferrari, Julia; Lang, Wilfried; Willeit, Johann; Kiechl, Stefan; Enzinger, Christian; Fazekas, Franz

doi:10.1161/strokeaha.118.022863

Cited by 95 publications

(85 citation statements)

References 31 publications

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“…The early mortality in our study (31.1%) was similar to those observed in African context, in Ghana (32.7%) [16]. In contrast, the 7-day mortality was lower in western countries where stroke unit is available (2%) [17]. The majority of stroke mortality (79.7%) occurred in the first 7 days, in line with Heuschman et al (66%) [18] but in contrast with Das et al who had found that 50% of case fatality occurred in 7-14 days [19].…”

Section: Discussionsupporting

confidence: 86%

Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso

Dabilgou

Dravé²,

Kyelem

et al. 2020

Stroke Research and Treatment

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Objective. To determine the prevalence of ischemic stroke deaths and their predictive factors in the Emergency Department at Yalgado Ouedraogo University Teaching Hospital (YOUTH). Methodology. This was a retrospective study with an analytical and descriptive focus over a period of three years from January 1, 2015, to December 31, 2017. Results. During the study period, 302 acute ischemic stroke patients with a mean age of 62.2±14.26 years were included. Atrial hypertension was the most common vascular risk factor in 52.5%. On admission, 34.8% of patients had loss of consciousness. The mean time to perform brain CT was 1.5 days. The average length of stay was 4 days. Electrocardiogram, echocardiography, and cervical Doppler were not performed during hospitalization in ED. The mortality rate was 39%, respectively, 37.6% in male and 41.6% in female. The mean age of patients who died in ED was 63.6±13.52 years. Hypertension was the most common vascular risk factors in 54.2% of death. After logistic regression, the predictors of death were past history of heart disease, consciousness disorders, hyperthermia, hyperglycemia on admission, poststroke pneumonia, and urinary tract infection. Conclusions. Acute ischemic stroke was frequent in Emergency Department with high mortality rate. The mortality risk factors were the same than those found in literature. This higher mortality can be avoided by early diagnosis and an adequate management.

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Section: Discussionsupporting

confidence: 86%

Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso

Dabilgou

Dravé²,

Kyelem

et al. 2020

Stroke Research and Treatment

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“…The strength of our finding lies in the larger sample size and adjustment for some potential confounders validating the safety of APT prior to EVT, and previous research studies demonstrated that potential confounders such as, age, vascular risk factors (diabetes mellitus and atrial fibrillation), IVT and intra-arterial thrombolysis are predictors for the increase risk of sICH. [22][23][24][25] There has been limited evidence for the effects of oral APT preceding EVT on the clinical outcomes. Previous studies showed that APT did not improve Open access Open access patient's clinical outcomes or reduce the risk mortality at 3-month follow-up although recanalisation could be achieved.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of oral antiplatelet for patients who had acute ischaemic stroke undergoing endovascular therapy

Huo

Raynald

Jing³

et al. 2020

Stroke Vasc Neurol

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Background and purposeTo investigate the safety and efficacy of oral antiplatelet therapy (APT) for patients who had acute ischaemic stroke (AIS), receiving endovascular therapy (EVT).MethodsPatients were divided into non-APT group and APT (single APT or dual APT (DAPT)) group. The safety and efficacy endpoints at 3-month follow-up were symptomatic intracranial haemorrhage (sICH), recanalisation rate, clinical outcome and mortality.ResultsAmong 915 patients who had AIS, those in APT group (n=199) showed shorter puncture-to-recanalisation time, lower frequency of intravenous thrombolysis and more use of tirofiban compared with those in non-antiplatelet group (n=716) (p<0.05 for all). Oral APT was found to be associated with superior clinical outcome compared with non-APT (APT (44.2%) versus non-APT (41.1%)), adjusted OR=2.605, 95% CI 1.244 to 5.455, p=0.011). DAPT showed superior clinical outcome compared with non-APT (DAPT (56.5%) versus non-APT (41.1%), adjusted OR=5.405, 95% CI 1.614 to 18.102, p=0.006) and lower risk of mortality at 3-month follow-up (DAPT (4.8%) versus non-DAPT (17.7%), adjusted OR=0.008, 95% CI 0.000 to 0.441, p=0.019). There was no significant difference in sICH between the two groups.ConclusionsOral APT prior to undergoing EVT is safe and may accompany with superior clinical outcomes. DAPT may associate with superior clinical outcomes and lower risk of mortality.

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“…There are many factors that affect in-hospital mortality in patients with acute ischemic stroke (AIS) [1]. These include the patient's age and severity of AIS, which are the strongest determinants of prognosis in the acute phase of stroke [2].…”

Section: Introductionmentioning

confidence: 99%

The Correlation of Routine Hematological Parameters with In-hospital Mortality and Length of Hospital Stay in Patients with Large Middle Cerebral Artery Infarction

Güneş

2020

Cureus

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Neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) reflect inflammation and these parameters have not been studied in patients with large cerebral artery infarction. This study investigated the correlation of these inflammation parameters with inhospital mortality and length of hospital stay (LOS) in patients with large middle cerebral artery (MCA) infarction. Materials and methods The study was conducted with patients who had large MCA (M1 and M2 segments) infarction. Clinical data of the patients and laboratory results at presentation were obtained from our database and recorded for statistical analysis. Multivariate logistic regression analysis was used to investigate the prognostic factors. The correlation between hematological parameters and LOS was investigated using Spearman's Rho and Pearson correlation tests. Results A total of 143 patients (48 patients with hospital mortality, 95 patients without hospital mortality) were included in the study. The median LOS in patients with hospital mortality [10 (2-90) days] was significantly higher compared to the patients without [7 (2-30) days] (p = 0.024). RDW-SD was found to be a poor prognostic factor according to the multivariate logistic regression model (p = 0.004). There was a significant but weak and positive correlation between LOS and NLR (p = 0.003, r: 0.248) and a significant but weak and negative correlation between LOS and eosinophil count (p = 0.001, r:-0.278). Conclusions High RDW at presentation is a poor prognostic factor in terms of in-hospital mortality in patients with large MCA infarction. In addition, a positive correlation has been found between NLR and LOS.

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Predicting Early Mortality of Acute Ischemic Stroke

Cited by 95 publications

References 31 publications

Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso

Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso

Safety and efficacy of oral antiplatelet for patients who had acute ischaemic stroke undergoing endovascular therapy

The Correlation of Routine Hematological Parameters with In-hospital Mortality and Length of Hospital Stay in Patients with Large Middle Cerebral Artery Infarction

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