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Predictors of outcome after acute ischemic stroke
M M Sumer1, I Ozdemir, N Tascilar
1Faculty of Medicine, Neurology Department, Zonguldak Karaelmas University, Bayindir Medical Center, Birlik Mah.20.Sok.NO:21/11, 06610 Cankaya, Ankara, Turkey. mmsumer@ixir.com
Acta Neurologica Scandinavica
|April 5, 2003
Summary
Neurologic deficit severity, measured by the Canadian Neurological Scale, is the key predictor of outcomes following acute ischemic stroke. Posterior circulation infarction also indicates a poor prognosis at hospital discharge.
Area of Science:
- Neurology
- Stroke Medicine
- Clinical Outcomes Research
Background:
- Acute ischemic stroke poses a significant global health challenge.
- Predicting patient outcomes is crucial for effective treatment and resource allocation.
- Identifying reliable prognostic indicators remains an active area of research.
Purpose of the Study:
- To identify key predictors of clinical outcomes in patients with acute ischemic stroke.
- To evaluate prognostic variables at hospital discharge and at the six-month follow-up.
- To establish the most significant factors influencing recovery and mortality post-stroke.
Main Methods:
- A cohort of 266 patients with acute ischemic cerebrovascular disease was analyzed.
- Patients were assessed within 24 hours of symptom onset.
- Outcomes were categorized as independent (Rankin Scale ≤2) or dependent (Rankin Scale >3) and death, with analysis of baseline characteristics, clinical variables, risk factors, infarct subtypes, and radiologic parameters.
Main Results:
- Canadian Neurological Scale (CNS) score <6.5 on admission was a strong predictor of poor outcome at discharge (OR 22) and at 6 months (OR 14).
- Posterior circulation infarction was associated with a poor outcome at hospital discharge (OR 4.2).
- The severity of neurologic deficit demonstrated a significant association with both short-term and long-term clinical outcomes.
Conclusions:
- Neurologic deficit severity is the paramount predictor for clinical outcomes in acute ischemic stroke patients.
- Posterior circulation infarction is an additional significant predictor of poor outcomes specifically at hospital discharge.
- These findings underscore the importance of early neurologic assessment and infarct location in stroke prognostication.