Abstract P627: Sleep Apnea Risk is Independently Associated With Functional Outcome After Stroke

Abstract

Introduction: Obstructive sleep apnea (OSA) is highly prevalent after stroke and associated with stroke recurrence. Several clinical scales have been used to predict OSA, but their relevance for functional outcomes are unknown. Objective: We aimed to determine if a sleep apnea risk score is associated with functional outcome in stroke patients. Methods: Consecutive patients with imaging-confirmed ischemic stroke were recruited from a public hospital in Salvador, Brazil. Demographic and cerebrovascular risk factor data were collected prospectively. We used NIH stroke scale (NIHSS) to quantify stroke severity and STOP-BANG questionnaire to quantify risk of OSA on admission (0 to 8, higher scores indicating higher risk). Patients were followed for 90 days and functional outcome was assessed by modified Rankin Scale (mRS). Poor outcome was defined as a mRS = 3 to 6. Results: We recruited 382 patients with ischemic stroke between October, 2018 and November, 2019, mean age 64 +/- 13 years, 189 (49.5%) female, median NIHSS 8 (interquartile range - IQR - 6 to 14) and median STOP-BANG score 5 (IQR 4 to 5). After 90 days, 216 (56.5%) had poor outcomes. Median STOP-BANG score was higher in patients with poor, when compared to good outcomes (4 vs 3, respectively, p=0.001). In multivariable logistic regression, STOP-BANG score was independently associated with poor outcome (odds ratio 1.56, 95% confidence interval 1.02 to 2.63, p=0.003), after adjustment for age, sex, NIHSS, cerebrovascular risk factors and stroke etiology. When STOP-BANG score was stratified by OSA risk, patients with mild, moderate and high OSA risk reached poor outcomes in 38.2%, 58.7% and 62.1%, respectively (p=0.004). Conclusions: A simple sleep apnea risk score (STOP-BANG) is independently associated with poor functional outcome in ischemic stroke patients.