[Recurrent ischemic stroke. Study of 605 patients].

Abstract

BACKGROUND AND OBJECTIVES:

To characterize the clinical factors and prognosis and identify determinants of ischemic stroke recurrence in acute stroke.

PATIENTS AND METHODS:

Recurrent stroke patterns were studied in 605 consecutive patients admitted with a second or further ischemic stroke to the Department of Neurology of the Sagrat Cor Hospital of Barcelona over a 17 year period. Demographic, risk factors, clinical, neuroimaging and outcome variables were analyzed and compared with patients with first-ever cerebral infarction (n=2.099) to identify predictors of ischemic recurrent stroke. Significant variables were entered into a multivariate logistic regression analysis.

RESULTS:

Ischemic recurrent strokes accounted for 22.4% of all acute consecutive ischemic strokes. Frequency of ischemic stroke recurrence were significantly different among ischemic stroke subtypes: 26.2% in atherothrombotic, 24.4% in cardioembolic, 21.8% in lacunar stroke, 15.8% in infarcts of unusual etiology and 12% infarctions of uncertain etiology. The overall in-hospital mortality and symptom free at discharge in recurrent vs. non-recurrent stroke patients rate was 16.2 vs. 12% (p=0.005) and 17.8 vs. 27.3% (p=0.0001) respectively. Previous intracerebral hemorrhage (OR=3.07; 95% CI, 1.51-6.25), intermittent claudication (OR=1.39; 95% CI, 1.01-1.90), arterial hypertension (OR=1.32; 95% CI, 1.09-1.59), diabetes mellitus (OR=1.26; 95% CI, 1.02-1.56), age (OR=1.02; 95% CI, 1.01-1.03), female gender (OR=0.63; 95% CI, 0.52-0.77), headache (OR=0.62; 95% CI, 0.44-0.87) and bulbar topography (OR=0.21; 95% CI, 0.05-0.89) were independent clinical variables related to ischemic stroke recurrence.

CONCLUSIONS:

About one in every four patients with ischemic stroke had an ischemic stroke recurrence. In-hospital mortality is 16.2% and clinical profiles were different in ischemic stroke recurrence when compared to first-ever ischemic stroke patients.

• Authors: Adrià Arboix, Joan Massons, Luís García-Eroles, Emili Comes, Miquel Balcells, Montserrat Oliveres
• Journal: Medicina clinica (Med Clin (Barc)) Vol. 137 Issue 12 Pg. 541-5 (Nov 12 2011) ISSN: 1578-8989 [Electronic] Spain
• Vernacular Title: Infartos cerebrales recurrentes: estudio de 605 pacientes.
• PMID: 21420134 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 Elsevier España, S.L. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Brain Damage, Chronic (epidemiology, etiology)
• Brain Ischemia (epidemiology)
• Cerebral Infarction (epidemiology)
• Diabetes Mellitus (epidemiology)
• Female
• Heart Diseases (epidemiology)
• Hospital Mortality
• Humans
• Hypertension (epidemiology)
• Intermittent Claudication (epidemiology)
• Ischemic Attack, Transient (epidemiology)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Prognosis
• Recurrence
• Risk Factors
• Spain (epidemiology)
• Treatment Outcome