Prognosis of Early-Stage Continuous Electrocardiogram Abnormalities on Patients with Acute Ischemic Stroke
Beisi Jiang1, Xiang Han1, Liang Wang1
1Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
Insights
Early electrocardiogram (ECG) abnormalities in acute ischemic stroke patients predict poor prognosis. Persistent ECG changes within 48 hours and at 7 days are independent predictors of worse outcomes.
Area of Science:
- Cardiology
- Neurology
- Clinical Medicine
Background:
- Cardiac dysfunction is a significant clinical challenge following acute ischemic stroke.
- Early identification of cardiac complications is crucial for patient management.
- This study investigates the prognostic value of early electrocardiogram (ECG) abnormalities.
Purpose of the Study:
- To determine the effect of the onset time of ECG abnormalities in early acute ischemic stroke on patient prognosis.
- To assess the correlation between the presence and persistence of ECG abnormalities and stroke outcomes.
Main Methods:
- Retrospective analysis of medical records from 351 patients across 23 hospitals.
- Statistical comparisons using Chi-square, Kruskal-Wallis, and Mann-Whitney U tests.
- Logistic regression analysis to identify predictors of poor prognosis (modified Rankin Scale >1).
Main Results:
- 70.1% of patients exhibited ECG abnormalities within 48 hours of stroke onset.
- 45.9% had persistent ECG abnormalities at both 48 hours and 7 days post-onset.
- Patients with ECG abnormalities had a significantly higher incidence of poor prognosis (56.3% vs. 32%).
- Persistent ECG abnormalities within 48 hours and at 7 days were independent predictors of poor prognosis.
Conclusions:
- Abnormal electrocardiograms (ECGs) are common in acute ischemic stroke patients.
- The timing and persistence of ECG abnormalities are critical indicators of patient prognosis.
- Early and persistent ECG changes signal a higher risk of adverse outcomes.
Background:
To explore the effects of onset time of electrocardiogram (ECG) abnormalities at an early stage of acute ischemic stroke on patient prognosis. Cardiac dysfunction after stroke is a challenge for clinicians. This is a retrospective study of patients in the neurology departments of 23 hospitals in Shanghai and Wuhan, China.
Methods:
The medical records of 351 patients were compared. Chi-square, Kruskal-Wallis, Mann-Whitney U tests, and stratification compared subgroups. Logistic regressions analyzed factors associated with modified Rankin Scale (mRS) score.
Results:
ECG abnormalities occurred in 70.1% of patients at an early stage (most were within 48 hours of disease onset) at least once, whereas 45.9% of the patients had ECG abnormalities within 48 hours of onset and at 7 days after onset. The incidence of poor prognosis (mRS >1) was significantly higher in the patients with ECG abnormalities for both time points than that in those with normal ECGs (56.3% versus 32%, odds ratio = 2.166). Most patients demonstrated 1 to 2 ECG abnormalities, and very few patients had 3 or more. Increasing number of ECG abnormalities was mirrored by poorer prognosis. ECG abnormalities occurred within 48 hours and at the seventh day after onset of acute ischemic stroke; the abnormalities that appeared within 48 hours and were still found on the seventh day after onset of the disease were independent predictors of poor patient prognosis.
Conclusions:
The incidence of abnormal ECGs was high in the patients with acute ischemic stroke, and the abnormal ECGs could appear at any stage of the disease.
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