Pre-stroke factors (morbitities, diet, medication, demograhics) that affect the severity of a stroke

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BackgroundThe goal of this study is to elucidate clinical characteristics in patients with acute ischemic stroke (AIS) that are associated with a potential improvement or worsening neurologic function who previously were taking an anti-hypertensive medication and then received recombinant tissue plasminogen activator (rtPA). MethodsThe binary logistical regression model was developed to identify clinical determinants that are associated with an improving or worsening neurologic function in AIS patients taking an anti-HTN medication who received thrombolytic therapy. The area under the receiver operating curve was used to determine the sensitivity of the model. ResultsIn the adjusted analysis for AIS population on combined rtPA and an anti-HTN medication therapy, increasing age (Odd ratio; OR = 1.035, 95% CI, 1.022–1.049, P < 0.001), female (OR = 1.630, 95% CI, 1.182–2.248, P = 0.002), and history of substance abuse (OR = 2.315, 95% CI, 1.107–4.842, P = 0.026) were associated with a worsening neurologic function. Caucasian patients (OR = 0.535, 95% CI, 0.361–0.793, P = 0.002), with the clinical presentations of dyslipidemia (OR = 0.655, 95% CI, 0.479–0.897, P = 0.008), obesity (OR = 0.642, 95% CI, 0.472–0.873, P = 0.005), HDL (OR = 0.988, 95% CI, 0.976–1.000, P = 0.045), and directedly admitted for treatment (OR = 0.509, 95% CI, 0.341–0.761, P = 0.001) were associated with improving neurologic function. In AIS who received rtPA and were not taking an anti-HTN medications, increasing age (OR = 1.021, 95% CI, 1.004–1.038, P = 0.015) and improvement in ambulation (OR = 1.762, 95% CI, 1.077–2.882, P = 0.024) were associated with a worsening neurologic function, while a direct admission (OR = 0.317, 95% CI, 0.158–0.635, P = 0.001) was correlated with progressing neurologic function. ConclusionOur findings reveal specific demographic and clinical risk factors that are associated with worsening or improving neurological functions in AIS pretreated with an anti-HTN medication with a subsequent thrombolytic therapy. This finding suggests the development of management strategies to manage identified clinical risk factors in AIS pretreated with an anti-HTN medication prior to thrombolytic therapy.