Cerebral leukoaraiosis in patients with stroke or TIA: clinical correlates and 1‐year outcome

Abstract

Cerebral leukoaraiosis is frequently observed in patients with acute stroke, but its clinical consequences on functional recovery remain incompletely defined. We evaluated the clinical correlates of leukoaraiosis, and its association with stroke-outcome in a cohort of consecutively hospitalized patients. One-thousand twenty-four consecutive patients with acute stroke or transient ischemic attack (TIA) undergoing brain CT were included in this single-center study. Patients were systematically evaluated at hospitalization and followed-up for 1 year. Mortality, functional outcome, quality of life (QoL), psychological distress, community integration, and patient perception of recovery were evaluated by leukoaraiosis severity. Adjusted ORs (95%CI) were calculated. Moderate/severe leukoaraiosis was diagnosed in 177 patients (17.3%) and mild leukoaraiosis in 362 patients (35.3%). After 1 year, adjusted ORs for moderate/severe leukoaraiosis compared with no leukoaraiosis were 2.0 (95%CI 1.1-4.0) for Barthel Index <or=75; 1.9 (95%CI 0.9-4.0) for help needed in ADL; 2.5 (95%CI 1.0-6.3) for not feeling totally recovered; 2.0 (95%CI 1.1-4.1) for low QoL; 1.9 (95%CI 1.0-3.5) for psychological distress, and 1.6 (95%CI 0.9-2.9) for reduced community integration. In a large cohort of consecutive patients hospitalized for stroke or TIA, leukoaraiosis predicted poor functional recovery, worse QoL and community integration, and higher psychological distress during the first year following stroke onset.