Related Experiment Video
Updated: Mar 17, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Outcome Predictors in First-Ever Ischemic Stroke Patients: A Population-Based Study
Giovanni Corso1, Edo Bottacchi1, Piera Tosi1
1Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy.
Insights
Very old age and cardiac embolism predict ischemic stroke severity. These factors, along with comorbidities, independently influence long-term mortality after stroke.
Area of Science:
- Neurology
- Epidemiology
- Cardiology
Background:
- Limited population-based data exists on predictors of first-ever ischemic stroke severity and long-term mortality.
- Understanding these predictors is crucial for patient management and prognosis.
Purpose of the Study:
- To characterize patients with first-ever ischemic stroke.
- To identify independent predictors of stroke severity and long-term mortality.
Main Methods:
- Utilized data from the population-based Cerebrovascular Aosta Registry (2004-2008).
- Included 1057 patients with first-ever ischemic stroke.
- Employed multivariate logistic regression, Kaplan-Meier estimates, and Cox proportional Hazards models.
Main Results:
- Predictors of stroke severity included very old age, female gender, atrial fibrillation, low ejection fraction, and cardioembolism.
- Predictors of long-term mortality included very old age, prestroke high modified Rankin Scale, high Charlson Index, atrial fibrillation, and stroke severity.
- Very old age (OR 2.98) and cardioembolism (OR 2.0) were key predictors of severity.
Conclusions:
- Very old age and cardiac embolism are independent predictors of ischemic stroke severity.
- These factors, combined with comorbid conditions, independently impact long-term mortality post-ischemic stroke.
Abstract:
Background. There is scant population-based information regarding predictors of stroke severity and long-term mortality for first-ever ischemic strokes. The aims of this study were to determine the characteristics of patients who initially presented with first-ever ischemic stroke and to identify predictors of severity and long-term mortality. Methods. Data were collected from the population-based Cerebrovascular Aosta Registry. Between 2004 and 2008, 1057 patients with first-ever ischemic stroke were included. Variables analysed included comorbidities, sociodemographic factors, prior-to-stroke risk factors, therapy at admission and pathophysiologic and metabolic factors. Multivariate logistic regression models, Kaplan-Meier estimates, and Cox proportional Hazards model were used to assess predictors. Results. Predictors of stroke severity at admission were very old age (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.75-5.06), female gender (OR 1.73, 95% CI 1.21-2.40), atrial fibrillation (OR 2.76, 95% CI 1.72-4.44), low ejection fraction (OR 2.22, CI 95% 1.13-4.32), and cardioembolism (OR 2.0, 95% CI 1.36-2.93). Predictors of long-term mortality were very old age (hazard ratio [HR] 2.02, 95% CI 1.65-2.47), prestroke modified Rankin scale 3-5 (HR 1.82; 95% CI 1.46-2.26), Charlson Index ≥2 (HR 1.97; 95% CI 1.62-2.42), atrial fibrillation (HR 1.43, 95% CI 1.04-1.98), and stroke severity (HR 3.54, 95% CI 2.87-4.36). Conclusions. Very old age and cardiac embolism risk factors are the independent predictors of stroke severity. Moreover, these factors associated with other comorbid medical conditions influence independently long-term mortality after ischemic stroke.
