Document Detail


Atherosclerotic burden and early mortality in acute ischemic stroke.
MedLine Citation:
PMID:  17502469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The influence that previous clinical expressions of systemic atherosclerosis may have on evolution and early mortality in patients with acute ischemic stroke is not known. OBJECTIVE: To evaluate the influence that atherosclerotic burden (ATB), assessed by a simple clinical scale, has on the 30-day mortality in patients with first-ever ischemic stroke. DESIGN: Retrospective review of case series from a prospective stroke record. An ATB score ranging from 0 to 2 was created using the history of ischemic heart disease and peripheral arterial disease. The impact of this score on the 30-day mortality was analyzed by multivariate regression analysis. SETTING: Tertiary university hospital. Patients A total of 1527 patients with first-ever ischemic stroke. Main Outcome Measure Thirty-day mortality. RESULTS: The 30-day mortality rate was 13.8%. Multivariate regression analysis showed an association between the ATB score and the 30-day mortality (P<.001). Comparing patients having no previous ATB with those with an ATB score of 1 or 2, the odds ratio (OR) for 30-day mortality increased from 1.71 (95% confidence interval [CI], 1.06-2.75) for patients with an ATB score of 1 to 5.90 (95% CI, 2.48-14.04) for those with an ATB score of 2. Age (OR, 1.05; 95% CI, 1.03-1.08), National Institutes of Health Stroke Scale score at admission (OR, 1.22; 95% CI, 1.18-1.25), atrial fibrillation (OR, 1.61; 95% CI, 1.10-2.35), hyperlipidemia as protector (OR, 0.39; 95% CI, 0.25-0.60), and glycemia at admission (OR, 1.07; 95% CI, 1.02-1.12) were also predictors of 30-day mortality. CONCLUSION: Previous symptomatic atherosclerotic disease evaluated by a simple clinical score is an independent predictor of early mortality in patients with first-ever ischemic stroke.
Authors:
Jaume Roquer; Angel Ois; Ana Rodríguez-Campello; Meritxell Gomis; Elvira Munteis; Jordi Jiménez-Conde; Elisa Cuadrado-Godia; José E Martínez-Rodríguez
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  64     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-05-15     Completed Date:  2007-06-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  699-704     Citation Subset:  AIM; IM    
Affiliation:
Unitat d'Ictus, Servei de Neurologia, Hospital Universitari del Mar, IMIM - Hospital del Mar, Barcelona, Spain. 35826@imas.imim.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atherosclerosis / etiology*
Brain Ischemia / complications*,  mortality*
Chi-Square Distribution
Confidence Intervals
Female
Humans
Male
Odds Ratio
Predictive Value of Tests
Regression Analysis
Retrospective Studies
Risk Factors
Severity of Illness Index
Sex Factors
Stroke / complications*,  epidemiology,  mortality*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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