Post-Stroke Outcomes of Patients with Chronic Obstructive Pulmonary Disease

Research has shown that patients with ischemic stroke and coexisting obstructive respiratory disorders have worse clinical status on admission and increased long-term mortality. Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of stroke, and the risk is even greater after exacerbation of COPD. Moreover, COPD and stroke share major risk factors, which are advancing age and smoking. The aim of this study was to analyze the incidence of complications and mortality in acute ischemic stroke (AIS) patients with and without COPD.

We analyzed prospectively collected data of 1022 patients with acute is-chemic stroke hospitalized in a district general hospital. The patients were divided into two groups-with coexisting COPD and without COPD.

Logistic regression analysis, which allowed for potential confounders, showed an association between coexisting COPD and the fol-lowing complications in acute ischemic stroke patients: heart failure (OR = 1.879, p = 0.048), atrial fibrillation (OR = 4.746, p = 0.012), delirium (OR = 2.803, p < 0.001), pneumonia (OR = 2.424, p = 0.005), bronchospasm (OR = 3.400, p = 0.023), and out-hospital mortality (OR = 2.656, p = 0.001).

Patients presenting with acute ischemic stroke and coexisting COPD significantly more often had cardiac and pulmonary complications, as well as delirium following stroke. In a long-term follow-up, the probability of one-year survival was significantly lower in AIS patients with co-existing COPD.