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Predictors of functional outcome in first-ever ischemic stroke: a special interest to ischemic subtypes, comorbidity
Nur Turhan1, Ayce Atalay, Haldun Muderrisoglu
1Baskent University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, Turkey. nurt@baskent-ank.edu.tr
Insights
Advanced age, high comorbidity, and large anterior circulation infarcts predict poor functional outcomes in first-ever ischemic stroke patients. These factors, along with admission functional status, are key indicators for rehabilitation success.
Area of Science:
- Neurology
- Cardiology
- Rehabilitation Medicine
Background:
- Cardiovascular abnormalities increase stroke risk and disability.
- Understanding factors influencing stroke outcomes is crucial for patient care.
Purpose of the Study:
- To investigate associations between patient factors (age, comorbidity, cardiovascular issues) and stroke lesion characteristics with functional outcomes in first-ever ischemic stroke patients.
- To identify predictors of functional recovery in stroke survivors.
Main Methods:
- Retrospective analysis of 129 first-ever ischemic stroke patients admitted to a rehabilitation center.
- Data collected included demographics, neuroimaging, cardiovascular parameters (ECG, echocardiography, carotid Doppler), lesion location/size (Oxfordshire Community Stroke Project), and comorbidity (Charlson Comorbidity Index).
- Functional outcome was measured using the Functional Independence Measure (FIM).
Main Results:
- Chronic atrial fibrillation and carotid stenosis were associated with total anterior circulation infarcts.
- Multivariate analyses identified age, adjusted Charlson Comorbidity Index, total anterior circulation infarcts, and admission FIM score as significant predictors of rehabilitation outcomes.
Conclusions:
- Advanced age, high comorbidity burden, large anterior circulation infarcts, and low admission FIM scores independently predict unfavorable functional outcomes.
- Hemodynamic comorbidities significantly impact the localization and extent of ischemic brain lesions.
Objectives:
Most cardiovascular abnormalities are associated not only with increased risk of certain ischemic stroke subtypes but also with markedly greater disability in stroke patients. We aimed to investigate the associations between age, comorbidity, cardiovascular problems, site and size of ischemic lesions and functional outcome in inpatient first-ever ischemic stroke patients.
Subjects:
A total of 129 first-ever ischemic stroke admissions to a university affiliated rehabilitation centre were involved.
Methods:
Demographic data, brain computerized tomography or magnetic resonance imaging reports of the patients were recorded. Cardiovascular parameters consisted of electrocardiographic, echocardiographic and carotid Doppler ultrasonographic findings. Location and size of ischemic lesions was determined by using the Oxfordshire Community Stroke Project classification. Charlson Comorbidity index adjusted for ischemic stroke was used to assess associated health problems. Functional recovery was defined as the improvements made on Functional Independence Measure.
Results:
Our data indicated that the presence of chronic atrial fibrillation and carotid stenosis had significant associations with total anterior circulation infarcts. Multivariate analyses revealed that age, Charlson Comorbidity index adjusted for ischemic stroke, total anterior circulation infarcts, Functional Independence Measure on admission were associated with rehabilitation outcomes.
Conclusions:
Advanced age, high comorbidity, large anterior circulation infarcts and poor functional level on admission were independent indicators of unfavorable functional outcome. Hemodynamic comorbidities had significant impact on localization and extend of ischemic lesions.
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01:15Ischemic Stroke l: Introduction
01:15Ischemic Stroke ll: Pathophysiology