Retrospective analysis of prognosis and risk factors of patients with stroke by TOAST

Abstract

To determine differences in 90-day mortality and identify risk factors among different etiological classifications of ischemic stroke using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification.Our retrospective analysis included 538 ischemic stroke patients. The cause of stroke was categorized according to the TOAST criteria, and 90-day mortality rates were obtained through the patient follow-up. Age, sex, previous medical history, and clinical features were used in the analysis of potential risk factors.There were 38 deaths during the 90-day follow-up period. Patients in the undetermined cause subgroups experienced significantly higher mortality rate than those in subgroups with small artery occlusion and large artery atherosclerosis. Factors independently associated with 90-day mortality for patients with the large artery atherosclerosis stroke subtype were age (95% confidence interval [CI], 1.010–1.192, P = .028), history of hypertension (95% CI, 3.030–99.136, P = .001), high blood glucose (95% CI, 1.273–2.354, P < .001), high cholesterol (95% CI, 0.017–0.462, P = .004), high uric acid (95% CI, 2.360–64.389, P = .003), and National Institute of Health Stroke Scale(95% CI, 1.076–1.312, P = .001). Age (95% CI, 1.012–1.358, P = .034) and high cholesterol (95% CI, 0.011–0.496, P = .007) were independently associated with 90-day mortality for patients with the small artery occlusion subtype of stroke.Our analysis identified that certain risk factors and 90-day mortality differ significantly among different stroke subtypes, as classified by the TOAST criteria. These risk factors must be considered carefully to provide the best clinical management of these patients and thus reduce mortality.

Epileptic activity in neurological deterioration after ischemic stroke, a continuous EEG study

“…Indeed, PDs tend to disappear spontaneously when associated to acute brain injury (García-Morales et al, 2002;Kim et al, 2006). Our retrospective cohort is probably biased towards more severe cases: mortality rate at three months is higher in our cohort (44%) compared to natural history of stroke patients where mortality rates range from 7% (Kolominsky-Rabas et al, 2001;Wei et al, 2018) to 23% (Feigin et al, 2003). Furthermore, only 7% of our stroke patients benefited from cEEG for ND, whereas ND is expected to occur in up to 38% of IS, suggesting that only the more severe cases underwent cEEG.…”

Prescription Patterns Of Antimigraine Drugs

“…This value is higher than other studies, where visits to general practitioners or internists do not exceed 70%. 24 In contrast, neurology consultations were much lower than reported in the United States by Ford et al, where this specialty treated 30% of patients with episodic migraines and up to 65% with chronic migraines. 24 This may indicate the limited access to this type of specialty for Colombian patients.…”

“…24 In contrast, neurology consultations were much lower than reported in the United States by Ford et al, where this specialty treated 30% of patients with episodic migraines and up to 65% with chronic migraines. 24 This may indicate the limited access to this type of specialty for Colombian patients. Other authors have found differences in prescriptions in relation to the caregiver, as was seen for some medications included in this study.…”

“…In a report of migraine sufferers in the USA, it was found that more than 90% had drug prescriptions for the acute management of their condition. 24 However, the differences are marked in terms of the medication administered, given that the study by Ford et al found that in acute management, mainly triptans and NSAIDs were used. In our study, ergo-tamine was found to be highly used.…”

Comparison of hemodynamic changes and prognosis between stenting and standardized medical treatment in patients with symptomatic moderate to severe vertebral artery origin stenosis

“…With the aging of the population and the rapid improvement in economic levels, the incidence of ischemic cerebrovascular disease based on atherosclerosis gradually increased. [9] Wang et al found that the hospital stay was significantly prolonged and the risk of stroke recurrence was significantly higher in stroke patients with atherosclerosis of the head and neck. [10]…”