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Is higher serum total cholesterol level associated with better long-term functional outcomes after noncardioembolic
Shin-Liang Pan1, I-Nan Lien, Tony Hsiu-Hsi Chen
1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Objective:
To investigate the prognostic effects of the serum total cholesterol (TC) levels on long-term functional outcomes in patients with first-time noncardioembolic ischemic stroke.
Design:
Cohort study.
Setting:
Referral center.
Participants:
Patients (N=109) with first-time ischemic stroke.
Interventions:
Not applicable.
Main Outcome Measure:
Serial Barthel Index (BI) scores at onset; 2 weeks; and 1, 2, 4, and 6 months after stroke. We analyzed the impact of the serum TC level and other clinical factors on the repeated measurements of BI scores at these 6 time points by using a linear mixed regression model.
Results:
Taking correlation across repeated measurement of BI scores, the TC level, baseline BI, follow-up time, and infarct size were identified as significant predictors for serial BI scores. Higher TC levels correlated with better functional outcomes. A 1-unit (mmol/L) increase in the TC caused a 3.12 (95% confidence interval [CI], .79-5.46) increase in the BI score after controlling for other clinical factors such as age, baseline functional status, and size of infarct. An elevation of 1 unit of baseline BI led to a .49 increase (95% CI, .38-.59) per unit in subsequent BI scores. A small infarct (<1cm) had higher BI scores than larger infarct by 9.09 (95% CI, 2.03-16.16).
Conclusions:
The serum TC level measured at the acute stage of noncardioembolic ischemic stroke is an independent predictor for long-term functional outcomes.
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