Progression in Lacunar Stroke is Related to Elevated Blood Viscosity

Abstract

Background: This study aimed to determine the relationship between neurological deterioration (ND) and blood viscosity (BV) in patients with lacunar stroke (LS).Methods: This was a single-hospital retrospective observational study of patients with LS. Patients were categorized into two groups: those with progressive symptoms and those without clinical worsening. Progression was defined as worsening by ≥2 points on the National Institutes of Health Stroke Scale (NIHSS) for motor function or ≥3 points on the total NIHSS score.Results: In total, 215 patients (26% of the total stroke population during the study period) who had experienced LS were screened for enrolment, and 182 were included in the final analysis. Of these, 40 patients (22%) showed clinical progressive symptoms. Among men, the progressive stroke group visited the hospital earlier with more severe symptoms than the non-progressive stroke group. Logistic linear regression analysis revealed that onset to admission ≤24 hours (odds ratio [OR], 4.03; 95% confidence interval [CI], 1.1-14.71; p=0.035), NIHSS ≥4 at admission (OR, 2.63; 95% CI, 1.03-6.71; p=0.043), systolic BV (OR, 3.57; 95% CI, 1.39-9.16; p=0.008), and diastolic BV (OR, 1.09; 95% CI, 1.02-1.16; p=0.012) were associated with progressive stroke. Whereas in women, only onset to admission ≤24 hour (OR, 17.92; 95% CI, 2.16-148.62; p=0.008) showed association.Conclusion: We found that admission within 24 hours, higher NIHSS score, and higher BV at admission were associated with an increased risk of ND in male patients with LS. Increased BV may play a role in reducing cerebral collateral circulation, thrombus propagation, or arterial reocclusion in progressive LS.