Abstract
Objectives
Patients’ previous disability (PD) is a key factor when considering acute stroke therapy.
PD's exact impact on functional prognosis of patients with acute ischemic stroke remains
not entirely clarified. We aimed to analyze PD's influence on functional outcome three
months after ischemic stroke.
Materials and methods
Retrospective analysis of prospectively collected data concerning patients with acute
ischemic stroke admitted to Stroke Unit of a tertiary center who underwent acute phase
therapy between 2017 and 2019. Modified Rankin Scale (mRS) was used to define PD (with
previous mRS≥3). Patients with PD were selected for treatment based on similar baseline
characteristics to patients without PD. Patients were classified into two groups according
to previous mRS: mRS<3 and mRS≥3. We defined bad outcome at three months after stroke
as mRS≥3 for patients with previous mRS<3, and as a higher score than baseline mRS
for patients with previous mRS≥3.
Results
We identified 1169 eligible patients – 1016 patients with previous mRS<3 and 153 patients
with previous mRS≥3. Most baseline characteristics did not differ significantly between
them. For patients ≤75 years old, PD was associated with worse outcome (odds ratio
estimate [OR] 4.50, p < 0.001). For patients >75 years old, PD was protective against worse outcome (OR
0.42, p < 0.001). In patients with previous mRS≥3 and >75 years old, there was a higher proportion
of women (p = 0.005).
Conclusions
PD might not be a relevant factor when considering acute stroke therapy in selected
patients >75 years old, especially women. Further studies are needed to clarify these
findings.
Key Words
Abbreviations:
PD (previous disability), mRS (modified Rankin scale), NIHSS (national institute of health stroke scale), TIA (Transient ischemic attack), INR (international normalized ratio), APTT (activated partial thromboplastin time), CT (computed tomography)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 27, 2021
Accepted:
October 17,
2021
Received in revised form:
October 15,
2021
Received:
July 13,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106183
Copyright
© 2021 Elsevier Inc. All rights reserved.
