Abstract TP94: Stroke Severity Scales Do Not Predict Adverse Hospital Outcome Variables In Young Stroke Patients: Results From A Regional Stroke Center Of Excellence

Abstract

Introduction: Acute ischemic stroke (AIS) among young patients is increasing in the US. This study sought to describe the risk factors, clinical characteristics, and hospital outcomes of young AIS patients who were treated in intensive care units (ICU). Methods: The current study was retrospective analysis of electronic healthcare data from a Regional Comprehensive Stroke Center of Excellence. The data was collected from admitted patients between Oct 2016 and Feb 2021 and included AIS patients between 18 and 45 years of age. Correlation and regression analysis were performed in order to understand the relation between risk predictors such as Acute Physiology and Chronic Health Evaluation (APACHE) IV score, Acute Physiology Score (APS), National Institute of Health Stroke Score (NIHSS), and Intensive Care after Thrombolytic (ICAT) and hospital outcomes. Results: There were 217 young AIS patients and 50.2% were males. More than half of the patients were white Hispanic (54%), followed by African American (24%), and whites (13%). Nearly 8% patients received intravenous thrombolysis, 2% endovascular reperfusion therapy, and 6% both treatments. Nearly 16% were smokers, 46% were hypertensive, 31% were dyslipidemic, 18% had previous stoke, 49% were obese or overweight, 18% were diabetic, 2% had carotid stenosis, 6% had CAD, and 1% had dysrhythmia. The mean (standard deviation) of APACHE, APS, NIHSS and ICAT scores were 5.0 (3.8), 33.8 (17.5), 5.5 (8.5), and 1.5 (1.5) respectively. Severity adjusted mean (SD) length of stay in hospital and ICU were 1.2 (0.9) and 1.2 (1.2) days, respectively. Severity adjusted ventilator days were 1.7 (2.1) days. Mean severity (SD) adjusted ICU and in-hospital mortality rates were 0.05 (0.54) and 0.60 (2.8) respectively. Analysis showed no association between risk predictors and adverse hospital outcome variables. Conclusion: Risk predictor scores did not predict adverse hospital outcomes in our AIS patients. Significant number of young AIS patients had chronic conditions which could have increased their stroke risk. Considering that majority of stroke risk factors are modifiable, strategies to decrease these risk factors to lower stroke rates should be prioritized among all these patients, independent of their risk scores.