Right insular infarction and mortality after ischaemic stroke.

Area of Science:

• Neurology
• Stroke Research
• Clinical Epidemiology

Background:

• Existing research indicates a link between insular infarction and patient mortality.
• Large infarcts frequently involve the insula, and infarct size correlates with mortality.
• The relationship between insular infarction and mortality, independent of lesion volume, requires further investigation.

Purpose of the Study:

• To determine if insular infarction is associated with mortality independently of lesion volume.
• To investigate the prognostic value of insular infarct location in ischemic stroke patients.

Main Methods:

• Analysis of 736 consecutive ischemic stroke patients from the 1000Plus database (2008-2012).
• Inclusion criteria: acute ischemic lesion on diffusion-weighted imaging and 90-day follow-up.
• Multiple Cox regression analysis adjusted for age, lesion volume, atrial fibrillation, NIH Stroke Scale, and prior stroke, with mortality as the dependent variable.

Main Results:

• 168 out of 736 patients had insular infarction.
• Patients with insular infarction had a cumulative survival of 90% versus 99% in those without (P < 0.001).
• Right insular infarction was independently associated with increased mortality (Hazard Ratio: 2.60; P = 0.010).

Conclusions:

• Right insular involvement serves as a prognostic marker for mortality following ischemic stroke.
• Further research is warranted to address potential selection bias in patient recruitment.