Stroke in Hospitalized Patients: Are There Special Risk Factors?

Abstract

Background and Purpose: The occurrence of stroke in patients hospitalized for various illnesses remains a particular challenge for neurologists. Determining the potential causes for these particular cerebrovascular events may help to define the population at risk and to take measures in order to prevent stroke during hospitalization. The aim of our study was to evaluate the potential risk factors associated with stroke, which occurred in patients hospitalized for other illnesses. Methods: This retrospective case-control study based on data of patients who underwent an ischemic stroke while being hospitalized not because of stroke and a control group of patients admitted during the same period who were matched for age and sex to the study patients. Common vascular risk factors, e.g. fever, leukocytosis, blood pressure, hemoglobin, cardiac arrhythmia and dehydration, were compared between the study and control groups. Results: Of 2,247 consecutive patients with ischemic stroke, the stroke had occurred during hospitalization not related to any surgical procedure in 80 (3.5%). Six parameters were found as being significant independent risk factors for in-hospital stroke: fever and leukocytosis during hospitalization, elevated diastolic and unstable blood pressure, dehydration and past history of myocardial infarction. Conclusion: Careful monitoring of temperature, blood count, blood pressure, and clinical and laboratory signs of dehydration is needed to prevent in-hospital stroke.

In-Hospital Stroke in a Statewide Stroke Registry

“…Compared to out-of-hospital stroke (OHS), cases of IHS are more likely to have an ischemic mechanism and are more likely to be embolic in origin [2, 12]. The spectrum of risk factors also differs for IHS cases; factors such as cerebrovascular stenosis [12, 13], atrial fibrillation [14,15,16], remote as well as recent myocardial infarction [14, 17], and elevated or unstable blood pressure [18], have all been reported to occur more frequently in cases with IHS.…”

“…Several prior studies on this topic are based on a small numbers of stroke cases, are limited to a small number of hospitals, or tend to focus on one particular aspect such as time of evaluation [3], stroke mechanism [2], risk factors [18], or outcomes [14]. In this study we describe a large case series of IHS cases that were identified as part of a representative statewide prospective hospital-based acute stroke registry.…”

Epidemiology and Outcomes of Fever Burden Among Patients With Acute Ischemic Stroke

“…7 In addition, fever has been found to be an independent risk factor for developing in-hospital stroke. 8 Previous studies have identified an infectious cause in 40% to 80% of poststroke patients with fever 3,7,9 ; the rest are of unknown etiology, and some are presumed to have a central cause. 2,10 Despite the evidence of poor poststroke outcomes with fever, little is known about the epidemiology of fever after stroke, or to what extent the severity of fever affects outcomes.…”

Increased Risk of Ischemic Stroke in Patients with Chronic Kidney Disease after Recurrent Dysnatremias: A Nationwide Population-Based Cohort Study

“…Second, a majority of hypernatremic patients are dehydrated. Studies have shown that dehydration is risk factor for ischemic stroke [26,27] because it can reduce cerebral blood flow and then precipitate in ischemic stroke and even result in sympathetic system activation, triggering the coagulation cascade [28]. However, the difference between hyponatremic and hypernatremic patients for the risk of stroke may be needed to further clarify in the future.…”