Leukoaraiosis rather than lacunes predict poor outcome and chest infection in acute ischemic stroke patients

In this study, we determine the effects of leukoaraiosis and lacunes on the clinical outcome and relative complications of acute ischemic stroke patients. From January 2007 to June 2008, 323 consecutive patients with acute brain infarction were prospectively studied. Leukoaraiosis was defined as moderate or severe white matter hyperintensities, and lacunes were counted as follows: none (0 lacune), few (1-2 lacunes), and many (≥3 lacunes). During a three-month period after the onset of stroke, patient outcomes and the incidence of complications were assessed. Backward stepwise logistic regression was used to identify the independent predictors of adverse outcome and complications after stroke. During the follow-up, 128 patients (39.63%) experienced adverse outcomes (i.e., death or disability), and 69 patients (21.36%) developed chest infections. Leukoaraiosis was an independent predictor of adverse outcome and chest infection (adverse outcome: odds ratio, 3.971, 95% confidence interval, 1.954-8.073; chest infection: odds ratio, 1.809, 95% confidence interval, 1.220-2.681), whereas no associations were observed between lacunes and adverse outcomes or complications after stroke. In conclusion, Leukoaraiosis but not lacunes was an independent predictor of adverse outcomes and chest infection in acute ischemic stroke patients. The difference between the effects of lacunes and leukoaraiosis may reflect the heterogeneity of these two primary features of small vessel diseases.