Predictors of Functional Outcome After Treatment of Acute Ischemic Stroke

Abstract

Background: Acute ischemic stroke (AIS) is a common condition with significant consequences. Advances in treatment modified outcome and prognosis. Aim: The present study aimed to discuss the predictors of functional outcome of AIS after the first three months. Patients and Methods: All the studied 131 patients had careful history taking, thorough clinical examination, and non-contrast brain CT scans. The initial severity of the stroke and evolution after thrombolysis was evaluated using the National Instituted of Health Stroke Scale (NIHSS). Patients were treated with low molecular weight heparin (LMWH) or rt-PA. Functional status at three months was evaluated using the modified Rankin Scale. Results: The present study included 131 patients with AIS. Favorable functional outcome was achieved in 52 patients (39.7 %) while the remainder 79 patients had a poor outcome. Using logistic regression analysis, significant predictors of poor outcome on univariate analysis included age ≥ 60 years (OR:3.2, CI: 1.3-7.9,p=0.014), presence of atheromatous plaques (OR: 16.8, CI: 4.8-58.3, p < 0.001), late initiation of treatment (OR: 10.6, CI: 3.4-32.1,p < 0.001) and persistent occlusion (OR: 7.8, CI: 3.2-18.8, p < 0.001). However, on multivariate analysis, variable predictive of poor outcome included age ≥ 60 years (OR: 32.5, CI: 5.4-196.5, p < 0.001), presence of atheromatous plaques (OR: 9.4, CI: 1.7-51.2, p= 0.01), late initiation of treatment (OR: 10.0, CI: 1.5-67.1,p= 0.018) and persistent occlusion (OR:25.7, CI: 6.9-95.8,p < 0.001). Conclusions: Independent predictors of poor outcome in AIS patients include age ≥ 60 years, presence of atheromatous plaques, late initiation of treatment, and persistent occlusion.