Abstract

Objective To investigate the correlation between prestroke comorbidity and long-term outcomes in patients with acute cerebral infarction. Methods Consecutive acute ischemic stroke patients who were hospitalized were prospectively recruited from August 2010 to November 2012. Six hundred and forty-four patients were enrolled, the baseline data including Charlson Comorbidity Index (CCI), National Institute of Health Stroke Scale (NIHSS) score, type of Oxfordshire Community Stroke Project (OCSP: total anterior circulation infarct, partial anterior circulation infarct, posterior circulation infarct and lacunar infarct) were recorded. And recovery was assessed by modified Rankin Scale (mRS) 90 days after stroke by telephone interview (mRS score≤2 reflected good prognosis, and mRS score>2 reflected unfavorable prognosis). Because CCI included specific comorbidity, we considered CCI, CCI without specific comorbidity and specific comorbidity as variable respectively. After screening the risk factors affecting prognosis using univariate analysis, the relationship between comorbidity and prognosis was estimated using multinomial logistic regression model. Results CCI was an independent predictor of good prognosis and unfavorable prognosis (OR=3.446, 95% CI 1.662—7.417; P=0.001). Congestive heart failure and diabetes were each independent predictor of good prognosis and unfavorable prognosis also (diabetes: OR=2.584, 95% CI 1.709—3.906, P=0.000; congestive heart failure: OR=6.229, 95% CI 1.705—22.755, P=0.006). Conclusions After acute ischemic stroke, the patients with the higher CCI score, diabetes and congestive heart failure are more likely to achieve unfavorable outcome. CCI, diabetes and congestive heart failure can each be used as a sensitive index to evaluate the 90 d prognosis of patients.(Trial registration: Clinical Research Center of China (CHiCTR-OCH-14004228)) Key words: Comorbidity; Brain infarction; Prognosis

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