Abstract 2510: Hemodialysis Is A Risk Factor For Short Or Long Term Mortality In Ischemic Stroke Patints.

Abstract

Background and purpose Hemodialysis(HD) is reported to be a risk factor for cerebrovascular events and poor prognosis. However, it is unclear whether HD is a risk factor for short or long term mortality in ischemic stroke patients. The aim of the present study was to investigate whether a short or long term mortality of stroke patient s receiving HD is higher than those without HD. Methods From April 2007 to May 2010, we retrospectively enrolled ischemic stroke patients within 24h of stroke onset who admitted to our hospital. We divided patients into two groups according to presence and absence of receiving HD(HD group and non-HD group) . We compared clinical characteristics and the mortality rate at discharge and 1year after stroke onset between the two groups. The factors associated with death were investigated by multivariate logistic regression analysis. Results 687 patients (417 males; (61.4%), mean age 72.4 ± 11 years) were enrolled. 29 patients (4.0%) had HD. HD group was younger(69.8±14.2 vs. 73.0±11.9 year,P<0.001), and hypertension(97%vs. 68%, P<0.001) and basilar artery occlusion(10% vs. 2%, P=0.01) were more frequently observed than non-HD group . In-hospital mortality was 6.7% (46/687 patients). HD group was high mortality rate compared with non HD group(21%vs. 6%, P=0.002). Multivariate logistic regression analysis demonstrated that higher NIHSS score on admission, (OR 1.2, 95% CI 1.109-1.207, P <0.001), basilar artery occlusion (OR 3.6, 95% CI 1.031-12.36, P = 0.05), and HD(OR 7.8, 95%CI 2.259-26.79, P = 0.001) were independent factors associated with in-hospital death. Next, after hospital discharge, 14.5% of patients died within 1 year. HD group was high mortality rate compared with non HD group(50%vs. 13%, P<0.001). On multivariate regression analysis, age per 1year increase(OR 1.0, 95%CI 1.015-1.078, P = 0.03), poor functional outcome (modified Ranking Scale (3-5)) at discharge (OR 2.0, 95%CI 1.635-2.599, P <0.001), and HD(OR 26.4, 95%CI 7.532-92.503, P <0.001) were independent factors associated with death within 1year of stroke onset. Therefore, HD was independently associated with short or long term mortality. Conclusions; HD is a risk factor for short or long term mortality in ischemic stroke patients.