Early neurological deterioration during the acute phase as a predictor of long-term outcome after first-ever ischemic stroke

Early neurological deterioration (END) is associated with increased risk of functional disability and mortality. However, data are limited regarding the long-term risk of poor functional outcomes. Thus we explored the association between END and long-term outcomes in patients with acute ischemic stroke. A total of 1064 patients were enrolled with acute ischemic stroke who were consecutively admitted to the 3 stroke units of Huai-He Hospital, Kaifeng, China. END was defined as an increment change of at least one point in motor power or total National Institute of Health Stroke Scale (NIHSS) score deterioration ≥2 points within the first week after admission. We retrospectively assessed the risk factors of END and prospectively explored the relationship between END and the long-term outcomes by multivariable regression models after adjusting the potential confounding factors. Outcomes were evaluated at 18 months based on modified Rankin scale (MRS) scores. Approximately 32% of first-ever ischemic stroke patients experienced END during the acute phase. END was associated with diabetes (odds ratio [OR], 2.218; 95% confidence interval [CI] 1.619–3.037), NIHSS score at admission (OR, 1.052; 95% CI 1.023–1.082), C-reactive protein (CRP) levels (OR, 1.224; 95% CI 1.066–1.406]), and homocysteine (HCY) levels (OR, 1.203; 95% CI 1.061–1.365) after adjusting related factors, such as hypertension, diabetes, NIHSS at admission, and some blood laboratory values, including direct...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research