Abstract
Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations. Materials and Methods. One hundred thirty-six patients (71 males and 65 females, median age 74 (65; 78)) with acute RCIHS were enrolled in the study. All patients underwent a detailed clinical and neurological examination using National Institutes of Health Stroke Scale (NIHSS), computed tomography of the brain, hematological, and biochemical investigations. In order to detect the dependent and independent risk factors of the lethal outcome of the acute period of RCIHS, univariable and multivariable regression analysis were conducted. A receiver operating characteristic (ROC) analysis with the calculation of sensitivity and specificity was performed to determine the prediction variables. Results. Twenty-five patients died. The independent predictors of the lethal outcome of acute RCIHS were: Baseline NIHSS score (OR 95% CІ 1.33 (1.08–1.64), p = 0.0003), septum pellucidum displacement (OR 95% CI 1.53 (1.17–2.00), p = 0.0021), glucose serum level (OR 95% CI 1.28 (1.09–1.50), p = 0.0022), neutrophil-to-lymphocyte ratio (OR 95% CI 1.11 (1.00–1.21), p = 0.0303). The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute RCIHS with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88–0.93), p < 0.0001).
Highlights
Stroke incidence, prevalence, mortality, and disability adjusted-life-year rates have declined over the last 20 years, the overall burden of stroke is still taking a lead position [1]
The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute recurrent cerebral ischemic hemispheric stroke (RCIHS) with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88–0.93), p < 0.0001)
We considered definition “recurrent cerebral ischemic hemispheric stroke” as any recurrent ischemic stroke occurring 24 h after the stroke onset in a different vascular region and any recurrent stroke occurring in the same region 21 days after the first-ever stroke
Summary
Prevalence, mortality, and disability adjusted-life-year rates have declined over the last 20 years, the overall burden of stroke is still taking a lead position [1]. The first five-year cumulative incidence of stroke recurrence varies between 16% and 30% in Western countries [2]. Recurrent stroke is relatively rare, but far more severe than first-ever stroke, is associated with longer duration of hospitalization and increased neurological disability, which makes this problem extremely relevant in medical, social, and economic aspects [3,4]. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
