Mathilde Graber1, Lucie Garnier1, Sophie Mohr1, Benoit Delpont1, Christelle Blanc-Labarre1, Catherine Vergely1, Maurice Giroud1, Yannick Béjot2. 1. Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France. 2. Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular Diseases (PEC2), University Hospital of Dijon, University of Burgundy, Dijon, France, ybejot@yahoo.fr.
Abstract
OBJECTIVE: We assessed the association between pre-stroke cognitive status and 90-day case-fatality. METHODS: Patients with ischemic stroke (IS) or spontaneous intracerebral hemorrhage (ICH) were prospectively identified among residents of Dijon, France, between 2013 and 2015, using a population-based registry. Association between pre-stroke cognitive status and case-fatality at 90 days was evaluated using Cox regression. RESULTS: Seven hundred sixty-two patients were identified, and information about pre-stroke cognitive status was obtained for 716 (92.6%) of them, including 603 IS (84.2%) and 113 ICH (15.8%). Before stroke, 99 (13.8%) patients had mild cognitive impairment (MCI) and 98 (13.7%) had dementia. Patients with cognitive impairment were older, had a higher prevalence of several risk factors, more severe stroke, more frequent ICH, and less admission to stroke unit. Case-fatality rate at 90 days was 11.7% in patients without cognitive impairment, 32.3% in MCI patients, and 55.1% in patients with dementia. In multivariable analyses, pre-existing MCI (hazard ratio [HR] 2.22, 95% CI 1.21-4.05, p = 0.009) and dementia (HR 4.35, 95% CI 2.49-7.61, p < 0.001) were both associated with 90-day case-fatality. CONCLUSION: Pre-stroke MCI and dementia were both associated with increased mortality. These associations were not fully explained by baseline characteristics, pre-stroke dependency, stroke severity or patient management, and underlying reasons need to be investigated.
OBJECTIVE: We assessed the association between pre-stroke cognitive status and 90-day case-fatality. METHODS:Patients with ischemic stroke (IS) or spontaneous intracerebral hemorrhage (ICH) were prospectively identified among residents of Dijon, France, between 2013 and 2015, using a population-based registry. Association between pre-stroke cognitive status and case-fatality at 90 days was evaluated using Cox regression. RESULTS: Seven hundred sixty-two patients were identified, and information about pre-stroke cognitive status was obtained for 716 (92.6%) of them, including 603 IS (84.2%) and 113 ICH (15.8%). Before stroke, 99 (13.8%) patients had mild cognitive impairment (MCI) and 98 (13.7%) had dementia. Patients with cognitive impairment were older, had a higher prevalence of several risk factors, more severe stroke, more frequent ICH, and less admission to stroke unit. Case-fatality rate at 90 days was 11.7% in patients without cognitive impairment, 32.3% in MCI patients, and 55.1% in patients with dementia. In multivariable analyses, pre-existing MCI (hazard ratio [HR] 2.22, 95% CI 1.21-4.05, p = 0.009) and dementia (HR 4.35, 95% CI 2.49-7.61, p < 0.001) were both associated with 90-day case-fatality. CONCLUSION: Pre-stroke MCI and dementia were both associated with increased mortality. These associations were not fully explained by baseline characteristics, pre-stroke dependency, stroke severity or patient management, and underlying reasons need to be investigated.
Authors: Jesse Dawson; Yannick Béjot; Louisa M Christensen; Gian Marco De Marchis; Martin Dichgans; Guri Hagberg; Mirjam R Heldner; Haralampos Milionis; Linxin Li; Francesca Romana Pezzella; Martin Taylor Rowan; Cristina Tiu; Alastair Webb Journal: Eur Stroke J Date: 2022-06-03
Authors: Hugo J Aparicio; Laura M Tarko; David Gagnon; Lauren Costa; Ashley Galloway; Serkalem Demissie; Luc Djousse; Sudha Seshadri; Kelly Cho; Peter W F Wilson Journal: Stroke Date: 2021-11-03 Impact factor: 7.914