PURPOSE: Since attention should be paid to acute stroke patients who may easily worsen, we investigated the predisposing factors for acute deterioration of minor ischemic stroke in Japanese patients. METHODS: We retrospectively investigated 543 patients who were admitted within 7 days of the occurrence of an acute minor stroke with National Institute of Health Stroke Scale (NIHSS) score of 4 or less, between January 2002 and September 2005. Deterioration of neurological findings was defined as the worsening by 2 points or more of the NIHSS score during admission to the hospital. RESULTS: Out of 543 patients, deterioration was noted in 37 patients (6.8%: deterioration group), and not in the other 506 patients (93.2%: non-deterioration group). Multivariate analysis demonstrated that the factors associated with worsening were atherothrombotic brain infarction (deterioration group vs. non-deterioration group: 35.1% vs. 18.0%, P=0.049), elevated systolic blood pressure (170.5+/-32.4 mm Hg vs. 160.4+/-27.4 mm Hg, P=0.033), serum glucose level on admission (146.1+/-60.5mg/dL vs. 121.7+/-54.9 mg/dL, P=0.048), and presence of paralysis (73.0% vs. 54.9%, P=0.003) and vertigo (16.2% vs. 7.9%, P=0.034). The more factors there were that were associated with worsening (atherothrombotic infarction; systolic blood pressure >140 mm Hg; serum glucose level >140 mg/dL; and paralysis, vertigo, and dizziness), the more frequently the deterioration occurred (number of worsening factors 0-2: 4.6%, 3: 12.8%, 4: 32.3%). Although over 80% of patients in the group without deterioration had good functional outcome at discharge, over 90% of patients with deterioration either were discharged to nursing home care or died. CONCLUSION: In this study, the predisposing factors for acute deterioration in minor ischemic stroke were atherothrombotic brain infarction; high blood pressure; elevated serum glucose level; and paralysis, vertigo, and dizziness. Once patients with minor ischemic stroke deteriorated, their functional outcome at discharge was significantly worse than those who had not deteriorated.
PURPOSE: Since attention should be paid to acute strokepatients who may easily worsen, we investigated the predisposing factors for acute deterioration of minor ischemic stroke in Japanese patients. METHODS: We retrospectively investigated 543 patients who were admitted within 7 days of the occurrence of an acute minor stroke with National Institute of Health Stroke Scale (NIHSS) score of 4 or less, between January 2002 and September 2005. Deterioration of neurological findings was defined as the worsening by 2 points or more of the NIHSS score during admission to the hospital. RESULTS: Out of 543 patients, deterioration was noted in 37 patients (6.8%: deterioration group), and not in the other 506 patients (93.2%: non-deterioration group). Multivariate analysis demonstrated that the factors associated with worsening were atherothrombotic brain infarction (deterioration group vs. non-deterioration group: 35.1% vs. 18.0%, P=0.049), elevated systolic blood pressure (170.5+/-32.4 mm Hg vs. 160.4+/-27.4 mm Hg, P=0.033), serum glucose level on admission (146.1+/-60.5mg/dL vs. 121.7+/-54.9 mg/dL, P=0.048), and presence of paralysis (73.0% vs. 54.9%, P=0.003) and vertigo (16.2% vs. 7.9%, P=0.034). The more factors there were that were associated with worsening (atherothrombotic infarction; systolic blood pressure >140 mm Hg; serum glucose level >140 mg/dL; and paralysis, vertigo, and dizziness), the more frequently the deterioration occurred (number of worsening factors 0-2: 4.6%, 3: 12.8%, 4: 32.3%). Although over 80% of patients in the group without deterioration had good functional outcome at discharge, over 90% of patients with deterioration either were discharged to nursing home care or died. CONCLUSION: In this study, the predisposing factors for acute deterioration in minor ischemic stroke were atherothrombotic brain infarction; high blood pressure; elevated serum glucose level; and paralysis, vertigo, and dizziness. Once patients with minor ischemic stroke deteriorated, their functional outcome at discharge was significantly worse than those who had not deteriorated.
Authors: James E Siegler; Karen C Albright; Alexander J George; Amelia K Boehme; Michael A Gillette; Andre D Kumar; Monica Aswani; Sheryl Martin-Schild Journal: Med Student Res J Date: 2017
Authors: Amelia K Boehme; Andre D Kumar; Adrianne M Dorsey; James E Siegler; Monica S Aswani; Michael J Lyerly; Dominique J Monlezun; Alexander J George; Karen C Albright; Timothy M Beasley; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2013-08-15 Impact factor: 2.136
Authors: Andre D Kumar; Amelia K Boehme; James E Siegler; Michael Gillette; Karen C Albright; Sheryl Martin-Schild Journal: J Stroke Cerebrovasc Dis Date: 2012-09-30 Impact factor: 2.136
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