Abstract
Introduction: Research has shown that patients with ischemic stroke and coexisting obstructive respiratory disorders have worse clinical status on admission and increased long-term mortality. Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of stroke, and the risk is even greater after exacerbation of COPD. Moreover, COPD and stroke share major risk factors, which are advancing age and smoking. The aim of this study was to analyze the incidence of complications and mortality in acute ischemic stroke (AIS) patients with and without COPD. Material and methods: We analyzed prospectively collected data of 1022 patients with acute is-chemic stroke hospitalized in a district general hospital. The patients were divided into two groups—with coexisting COPD and without COPD. Results: Logistic regression analysis, which allowed for potential confounders, showed an association between coexisting COPD and the fol-lowing complications in acute ischemic stroke patients: heart failure (OR = 1.879, p = 0.048), atrial fibrillation (OR = 4.746, p = 0.012), delirium (OR = 2.803, p < 0.001), pneumonia (OR = 2.424, p = 0.005), bronchospasm (OR = 3.400, p = 0.023), and out-hospital mortality (OR = 2.656, p = 0.001). Conclusion: Patients presenting with acute ischemic stroke and coexisting COPD significantly more often had cardiac and pulmonary complications, as well as delirium following stroke. In a long-term follow-up, the probability of one-year survival was significantly lower in AIS patients with co-existing COPD.
Highlights
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease characterized by persistently reduced airflow through the lungs with chronic inflammatory response, yet defined as a common, preventable, and treatable medical condition, with various degrees of severity and comorbidities [1]
Differences between the groups were observed for the presence of comorbidities, as more COPD patients had transient ischemic attack within 30 days prior to admission due to acute ischemic stroke (AIS) (p = 0.014), history of ischemic stroke in the past (p = 0.040), chronic renal failure (p = 0.009), extracardiac arteriopathy (p < 0.001)
Despite literature data suggesting a frequent coexistence of these two conditions [14–16], there has not been any research on the actual prevalence of COPD among ischemic stroke patients
Summary
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease characterized by persistently reduced airflow through the lungs with chronic inflammatory response, yet defined as a common, preventable, and treatable medical condition, with various degrees of severity and comorbidities [1]. It is the third most common disease contributing to death in the world [2,3]. Its pathophysiological hallmarks include chronic inflammation of the small airways that induces repeated damage and repair, which eventually result in the destruction of lung parenchyma, loss of elasticity, bronchiolar fibrosis and small airway obstruction, and emphysema with airspace dilatation [4]. Stroke is the leading cause of disability in the world and the second leading cause of death [7].
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