This preliminary study investigates the risk factor profile, post stroke complications, and outcome for four OCSP (Oxfordshire Community Stroke Project Classification) subtypes. One hundred seventeen consecutive ischemic stroke patients were clinically classified into 1 of 4 subtypes: total anterior (TACI), partial anterior (PACI), lacunar (LACI), and posterior (POCI) circulation infarcts. Study evaluations were performed at admission, 2 weeks, and 6 months. There was a good correlation between clinical classification and radiological diagnosis if a negative CT head was considered consistent with a lacunar infarction. No significant difference in risk factor profile was observed between subtypes. The TACI group had significantly higher mortality (P <.001), morbidity (P <.001, as per disability scales), length of hospital stay (P <.001), and complications (respiratory tract infection and seizures [P <.01]) as compared to the other three groups which were all similar at the different time points. The only significant difference found was the higher rate of stroke recurrence within the first 6 months in the POCI group (P <.001). The OCSP classification identifies two major groups (TACI and other 3 groups combined) who behave differently with respect to post stroke outcome. Further study with larger numbers of patients and thus greater power will be required to allow better discrimination of OCSP subtypes in respect of risk factors, complications, and outcomes if the OCSP is to be used to stratify patients in clinical trials. Copyright © 2003 by National Stroke Association
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Accepted: October 4, 2002
Received: August 27, 2002
*Supported in part by a grant from Schering AG, Ireland (S. J. P.).
**Address reprint requests to Sean J. Pittock, MD, Department of Neurology, 200 First Street SW, Mayo Clinic, Rochester, MN 55901.
© 2003 National Stroke Association. Published by Elsevier Inc. All rights reserved.