Abstract T P385: Cortical Deficits and Prior Stroke Predict Stroke Recurrence in Patients with Mild Deficits

Abstract

Background: Predictors of stroke recurrence after a transient ischemic attack have been studied and validated, however those in patients with mild deficits have not been established. Identifying predictors of stroke recurrence may help risk stratify patients based on their stroke risk. We hypothesize that patients with cortical deficits on the National Institute of Health Stroke Scale (NIHSS) (language, neglect, and visual) are at higher risk of stroke recurrence than those without these deficits independent of other known predictors of recurrence. Methods: Data was retrieved from the Stroke Warning Information and Faster Treatment (SWIFT) study dataset. All patients with NIHSS between 0 and 5 and not treated with intravenous thrombolysis were included. Patients were prospectively followed from December 2006 to June 2011. Adjusted logistic regression models assessed the relationship between stroke recurrence and cortical deficits, baseline demographics, risk factors, and NIHSS score. Results: The sample included 894 patients; 108 (12%) had recurrent stroke over the study period. Cortical deficits (OR=1.84, p=0.05) were a predictor of recurrent stroke independently of other well characterized predictors including age, gender, ethnicity, hypertension, diabetes, and atrial fibrillation; history of prior stroke (OR=2.35, p=0.001) was an additional predictor of recurrent stroke. The other variables (age, gender, ethnicity, hypertension, diabetes, and atrial fibrillation) were not associated with risk of recurrent stroke. Conclusion: Cortical deficits and a prior stroke are predictors of stroke recurrence in this sample of patients with minor stroke enrolled in a randomized clinical trial. This group may be a target for more aggressive stroke prevention measures.