Abstract Details

Title Identification of Modifiable and Non-Modifiable Risk Factors for Neurological Deterioration Following Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 052

Objective

Background BACKGROUND: ND following ischemic stroke has been previously shown to impact short-term functional outcome and is associated with in-hospital mortality.

Design/Methods DESIGN/METHODS: Consecutive patients with AIS who presented July 2008 - December 2010 were identified from a prospective registry and excluded for in-hospital stroke, presentation >48hrs since last seen normal, or unknown time of last seen normal. Baseline demographic, historical, imaging, and laboratory data, National Institutes of Health Stroke Scale (NIHSS) scores, and episodes of ND (increase in NIHSS score ?2 within a 24hr period) were investigated.

Results RESULTS: Of the 596 patients screened, 366 were included (median age 65, 42.1% female, 65.3% black). Of these, 128 (35.0%) experienced ND. Patients with ND were more likely to be older (69 vs. 62 y, p<0.0001), have a more severe stroke (median admission NIHSS 12 vs. 5, p<0.0001), have carotid artery stenosis (27.0% vs. 16.8%, p=0.0275) and a history of coronary artery disease (26.0% vs. 16.4%, p=0.0282) compared to patients without ND. While no difference was found in the prevalence of diabetes, patients with ND were more likely to have a higher serum glucose on admission than patients without ND (125.5 vs. 114 mg/dL, p=0.0036). The unadjusted odds of experiencing ND were greater in patients with cortical (OR=1.6 95%CI=1.0-2.6, p=0.0457) or anterior infarcts (OR=2.2 95%CI=1.1-4.7, p=0.0369).

Conclusions CONCLUSIONS: We found that older patients and patients with more severe strokes are more likely to deteriorate following hospital admission for stroke. Other risk factors for ND include atherosclerosis and hyperglycemia. Because initial stroke severity was found to be one of the most significant and independent risk factors for ND, recanalization and reperfusion after the ischemic insult may be the target for neuroprotection.

Authors/Disclosures
James E. Siegler III, MD (University of Chicago) PRESENTER	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
Amelia K. Boehme, PhD (Columbia University)	Dr. Boehme has nothing to disclose.
Andre Kumar	No disclosure on file
Michael Gillette	No disclosure on file
Joshua Z. Willey, MD, FAAN (Columbia University)	Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbott. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Edwards Scientific. Dr. Willey has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for RECARDIO. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BrainQ. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of the American College of Cardiology. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Uptodate. The institution of Dr. Willey has received research support from NIH. Dr. Willey has received personal compensation in the range of $500-$4,999 for serving as a Review chapter author, MKSAP 16-20 with American College of Physicians.
Karen C. Albright, DO, DO, PhD, MS, MPH (FDA)	Dr. Albright has nothing to disclose.
Sheryl Martin-Schild, MD, PhD, FAAN (Dr. Brain, Inc.)	No disclosure on file

��ɫ��

��ɫ��