Murat Sumer1, Iklim Ozdemir, Ozcan Erturk. 1. Neurology Department, Zonguldak Karaelmas University Medical Faculty, Neurology Department, 67700 Kozlu Zonguldak, Turkey. mmsumer@ixir.com
Abstract
BACKGROUND AND PURPOSE: The aim of this study was to investigate the frequency, possible predictive factors and the prognosis of deteriorating ischemic stroke. METHODS: A total of 266 stroke patients who presented within 24h of onset were enrolled. Clinical deterioration was defined as a decrease of > or =1 points in the Canadian Neurological Scale (CNS). Rankin Score (RS) was performed at discharge and at six months. RESULTS: Of the 266 patients studied, 26 (9.8%) worsened. Involvement of posterior circulation (odds ratio (OR) 3.16) and noncardioembolic infarction (OR 4.5) were found to be independently associated with neurological worsening. Death occurred in 19.2% of progressive (P) and in 4.16% of nonprogressive (NP) groups. Functional outcome was worse in the P than in NP patients at discharge and at sixth months. CONCLUSIONS: Involvement of posterior circulation and noncardioembolic subtypes of infarct independently affect neurological progression in acute ischemic stroke. Clinical deterioration significantly worsens the prognosis.
BACKGROUND AND PURPOSE: The aim of this study was to investigate the frequency, possible predictive factors and the prognosis of deteriorating ischemic stroke. METHODS: A total of 266 strokepatients who presented within 24h of onset were enrolled. Clinical deterioration was defined as a decrease of > or =1 points in the Canadian Neurological Scale (CNS). Rankin Score (RS) was performed at discharge and at six months. RESULTS: Of the 266 patients studied, 26 (9.8%) worsened. Involvement of posterior circulation (odds ratio (OR) 3.16) and noncardioembolic infarction (OR 4.5) were found to be independently associated with neurological worsening. Death occurred in 19.2% of progressive (P) and in 4.16% of nonprogressive (NP) groups. Functional outcome was worse in the P than in NP patients at discharge and at sixth months. CONCLUSIONS: Involvement of posterior circulation and noncardioembolic subtypes of infarct independently affect neurological progression in acute ischemic stroke. Clinical deterioration significantly worsens the prognosis.
Authors: James E Siegler; Amelia K Boehme; Andre D Kumar; Michael A Gillette; Karen C Albright; T Mark Beasley; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2012-12-16 Impact factor: 2.136