Factors associated with unfavorable outcome in minor ischemic stroke

Abstract

Objective To investigate the risk factors for unfavorable outcome in patients with minor ischemic stroke. Methods Patients with minor ischemic stroke were enrolled prospectively. The modified Rankin Scale (mRS) was used to assess the clinical outcome at day 90 after onset, and mRS 0-2 was defined as favorable outcome. The demographic data, vascular risk factors, clinical data, imaging data, stroke etiologic subtypes, laboratory test results, and treatment methods in the favorable outcome group and unfavorable outcome group were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for early poor outcome in patients with minor ischemic stroke. Results A total of 516 patients with minor ischemic stroke were enrolled. At day 90 after onset, 90 patients (17.44%) had unfavorable outcome and 426 (82.56%) had favorable outcome. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.045, 95% confidence interval [CI] 1.017-1.074; P=0.002), heart diseases (OR 2.021, 95% CI 1.063-3.841; P=0.032), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.662, 95% CI 1.177-2.347; P=0.004), limb movement disorder (OR 2.430, 95% CI 1.010-5.850; P=0.048), ataxia (OR 2.929, 95% CI 1.188-7.221; P=0.020), early neurological deterioration (OR 50.994, 95% CI 17.659-147.258; P<0.001), infarct diameter (OR 1.279, 95% CI 1.075-1.521; P=0.005), non-responsible vascular stenosis (OR 2.518, 95% CI 1.145-5.536; P=0.022), and large artery atherosclerotic stroke (OR 2.010, 95% CI 1.009-4.003; P=0.047) were the independent risk factors for unfavorable outcome in minor ischemic stroke. Conclusions The early poor outcome of minor ischemic stroke is closely associated with age, heart diseases, baseline NIHSS score, limb movement disorder, ataxia, early neurological deterioration, infarct diameter, non-responsible vascular stenosis, and large artery atherosclerotic stroke. The relevant examinations need to be improved early, the etiologic subtype should be identified, and the correct clinical treatment should be guided. Key words: Stroke; Brain Ischemia; Severity of Illness Index; Magnetic Resonance Imaging; Treatment Outcome; Risk Factors