Autonomic Dysfunction Predicts Clinical Outcomes After Acute Ischemic Stroke: A Prospective Observational Study

Area of Science:

• Neurology
• Cardiology
• Internal Medicine

Background:

• Central autonomic dysfunction is a known contributor to increased stroke morbidity and mortality.
• Assessing poststroke autonomic function is crucial for predicting patient outcomes.

Purpose of the Study:

• To investigate if autonomic dysfunction, evaluated using the Ewing battery, can predict clinical outcomes in patients following an ischemic stroke.

Main Methods:

• A prospective observational study involving 150 ischemic stroke patients assessed within 7 days of symptom onset.
• Autonomic function was measured using the Ewing battery and patients were stratified into minor or significant autonomic dysfunction groups.
• Clinical outcomes were assessed at 3 months using the modified Rankin Scale score.

Main Results:

• Significant autonomic dysfunction was identified in 76.0% of patients.
• A poor functional outcome at 3 months was observed in 32.5% of the significant autonomic dysfunction group versus 13.9% in the minor group (P=0.031).
• Autonomic dysfunction magnitude independently predicted unfavorable outcomes (OR, 3.263; P=0.027) after adjusting for confounding variables.

Conclusions:

• Autonomic dysfunction, as measured by the Ewing battery, serves as a significant predictor of poor functional outcomes in acute ischemic stroke patients.
• Early assessment of autonomic function may aid in identifying high-risk patients and guiding therapeutic strategies.