Evaluation of the outcome in ischemic stroke acute period

Abstract

Introduction. As a major cause of both temporary and permanent disability, ischemic stroke is the most common type of cerebrovascular accident (CVA).
 Objective. To assess fatal outcome probability in the acute period of ischemic stroke.
 Materials and methods. We performed post-hoc analysis of the fatal outcome probability in the patients with acute ischemic stroke at the Neurology Department of the Ufa Emergency Hospital, the Republic of Bashkortostan, Russian Federation. The analysis included data from the randomly selected medical records of 31 patients with fatal outcomes and 55 patients discharged with favorable outcomes.
 Results. The patients with fatal outcomes were significantly (p 0.001) older, with more severe strokes and a higher prevalence of disorders of consciousness, medical co-morbidities, and recurrent strokes as compared to the group of patients with favorable outcomes. Regression coefficients showed that brain herniation, kidney and liver disease, post-infarction cardiosclerosis, diabetes mellitus, and atrial fibrillation were associated with a higher probability of the fatal outcome. Increased severity of disorders of consciousness, NIHSS and mRS scores, specific blood tests values, age, and heart rate were associated with a more probable fatal outcome, while elevated hemoglobin, total protein, red blood cells, and lymphocytes, a higher GCS score, and a history of hypotensive drug therapy were associated with a less probable fatal outcome.
 Multivariate analysis showed that the stroke fatal outcome was related with the age, a NIHSS score, and elevated creatinine and total bilirubin levels.
 Conclusion. The detected predictors of the stroke fatal outcome can be used as reference points to choose management strategy for patients in the acute period of ischemic stroke.