Abstract Details

Title Clinical Factors Influencing Poor Functional Outcome on Discharge in Patients with Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 244

Objective

Background BACKGROUND: Many factors have been shown to result in poor functional outcomes in stroke. The influence of each factor in affecting functional outcomes of patients hospitalized with acute ischemic stroke has not been fully delineated in a prospective cohort.

Design/Methods DESIGN/METHODS: We conducted a prospective observational study on acute ischemic stroke patients presenting to a tertiary hospital from August 2010 to March 2011 in Singaproe. We included patients who were functionally normal (modified Rankin Score, mRS=0) prior to stroke. Demographics, National Institute of Health Stroke Scale (NIHSS) on admission, associated medical conditions, complications during hospital stay and mRS on discharge were recorded. We defined good outcome on discharge as mRS 0-2 (alive and independent) and poor outcome as mRS 3-6 (dependent or dead). We tested the association between outcomes and predictor variables using chi-square test for proportion or categorical data and student t-test for continuous data. We analyzed the significant predictors using multiple logistic regression to obtain the adjusted odds ratio for factors predicting poor outcomes.

Results RESULTS: 525 patients presented with acute ischemic stroke during the study period, 416 (79.2%) patients were functionally normal prior to stroke. 326 (68.9%) had good outcome on discharge while 147 (31.1%) had poor outcome. We identified pneumonia (odds ratio(OR): 8.8, 95%CI:2.0-38), presence of atrial fibrillation (OR: 5.1, 95%CI:1.3-20), poor educational status (OR:2.2, 95%CI:1.1-4.5) and high NIHSS score (OR: 1.5, 95%CI:1.3-1.6) as factors adversely associated with poor outcome in multiple logistic regression analysis. Pneumonia was the only modifiable factor identified.

Conclusions CONCLUSIONS: Pneumonia is the most important and also only modifiable factor that adversely influenced the functional outcome in patients with acute ischemic strokes on discharge. Predictive scoring and preventive strategies may reduce its incidence and improve patient's functional outcomes.

Authors/Disclosures
Tian Ming Tu, MD (Neurology Care Partners) PRESENTER	Dr. Tu has nothing to disclose.
	No disclosure on file
	No disclosure on file
Jori Ruuskanen (Turku University Hospital)	No disclosure on file
Kim En Lee, MBBS, MRCP (Lee Kim En Neurology Pte Ltd)	No disclosure on file
Fuki M. Hisama, MD, FAAN (UC Irvine)	An immediate family member of Dr. Hisama has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zogenix. The institution of Dr. Hisama has received research support from UW Brotman Baty Precision Medicine Institute. The institution of Dr. Hisama has received research support from NIH/NHGRI.

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