Clinical characteristics and short term mortality ischemic stroke patients with atrial fibrillation

This study aimed to explore the associations of piracetam use and the clinical characteristics of NIHSS (National Institute of Health Stroke Scale) changes—the importance of which, as prognosis related factors, was previously unnoticed—and analyze the associations of piracetem with NIHSS changes by stratifying clinical characteristics. This observational retrospective study was conducted by enrolling patients based on 2483 stroke registration data cohorts from a 1200-bed regional Tungs’ Taichung MetroHarbor Hospital, located in central Taiwan from 1 January 1 2011 to 31 December 2015. Patients were excluded if they had intravenous a thrombolytic agent within 3 hours of symptoms onset (n = 49), incomplete or erroneous NIHSS scores (n = 953), or transient ischemia stroke (n = 130). Logistic regression model was applied for associating piracetam treatment and clinical characteristics with NIHSS score changes between admission and discharge, and subgroup analysis to assess the conditions under which piracetam can be used. Multivariate analysis revealed NIHSS scores improvement in atrial fibrillation, large-artery atherosclerosis, underweight, current smoker, ex-smoker, and piracetam. Subgroup analysis showed piracetam is beneficial in the following: age ≥75 years olds, males, those of normal weight, those who are obese, ex-smokers, those with hypertension, dyslipidemia, those without diabetes mellitus, nor atrial fibrillation. The selection of the conditions under which piracetam treatment should be given, and clinical characteristics, is important for NIHSS improvement of ischemic stroke patients in Taiwan.

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Procalcitonin to C-reactive protein ratio is associated with short-term mortality in ischemic stroke patients: preliminary report

Archives of Medical Science ◽

10.5114/aoms.2020.100207 ◽

2020 ◽

Author(s):

Jooyoung Cho ◽

Seri Jeong ◽

Jong-Han Lee

Keyword(s):

Ischemic Stroke ◽

Preliminary Report ◽

C Reactive Protein ◽

Stroke Patients ◽

Short Term ◽

Protein Ratio ◽

Reactive Protein ◽

Short Term Mortality

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Effect of telestroke practices on short-term mortality in ischemic stroke patients

Journal of Contemporary Medicine ◽

10.16899/jcm.973616 ◽

2022 ◽

Vol 12 (1) ◽

pp. 127-133

Author(s):

Hatice Şeyma AKÇA ◽

Abdullah ALGIN ◽

Serdar ÖZDEMİR ◽

Fatma KOLBAŞ ◽

Emine YILMAZ ◽

...

Keyword(s):

Ischemic Stroke ◽

Stroke Patients ◽

Short Term ◽

Short Term Mortality

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T78. MORTALITY IN PATIENTS WITH SCHIZOPHRENIA ADMITTED FOR INCIDENT ISCHEMIC STROKE: A POPULATION-BASED COHORT STUDY

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.638 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S261-S261

Author(s):

Nicholas Chak Lam Yung ◽

Joe Kwun Nam Chan ◽

Corine Sau Man Wong ◽

Philip Chi Fai Or ◽

Wing Chung Chang

Keyword(s):

Cohort Study ◽

Ischemic Stroke ◽

Psychotic Disorders ◽

Index Admission ◽

Antipsychotic Treatment ◽

Stroke Mortality ◽

Stroke Patients ◽

Short Term ◽

Post Stroke ◽

Short Term Mortality

Abstract Background Evidence shows that schizophrenia is associated with increased incidence of cardiovascular diseases (CVD), including stroke. The relationship between schizophrenia and post-stroke mortality was understudied, and mixed findings were observed. Of note, none of these studies specifically explored the association of schizophrenia with short-term mortality after incident ischemic stroke. One of them specifically examined short-term mortality following ischemic stroke in schizophrenia patients, but it did not address potential confounding by patients who had past history of stroke. The only study which included solely incident stroke patients indicated that patients with psychotic disorders experienced higher short-term mortality ensuing incident stroke. Methods We conducted a retrospective cohort study to investigate short-term mortality of schizophrenia patients after incident ischemic stroke. All individuals admitted for incident ischemic stroke between 2006 and 2016 in Hong Kong were identified using a territory-wide electronic health record database. 817 patients with an ICD-10 diagnosis of schizophrenia (F20) or schizoaffective disorder (F25) (termed schizophrenia henceforth) prior to index admission constituted the study group. The comparison group comprised 8170 patients (10:1 matched to schizophrenia patients on age, sex, treatment sites and calendar-period for index admission) without any non-affective psychoses, mania or bipolar disorder (F20, F22-25, F28-31). Results Multivariate logistic regression revealed that schizophrenia patients had higher 1-year (OR [95% CI] = 1.51 [1.22 – 1.85]) and marginally higher 30-day (OR [95% CI] = 1.34 [1.00 – 1.79]) mortality following incident ischemic stroke, after adjusting for medical comorbidities, including hypertension, diabetes, hyperlipidemia, alcohol and substance use disorders and other comorbidities quantified by Charlson-Deyo comorbidity index. Additional age- (<65 years and ≥65 years) and gender-stratified analyses revealed similar results. Elevated 1-year mortality was exhibited by all schizophrenia subgroups, being more pronounced in younger patients (OR [95% CI] = 2.02 [1.38 – 2.96]). Increase in 30-day mortality was only seen in younger (OR [95% CI] = 1.75 [1.04 – 2.95]) and male (OR [95% CI] = 1.63 [1.06 – 2.50]) schizophrenia patients. Discussion Our results of heightened short-term post-stroke mortality in schizophrenia were in line with the only previous study which compared short-term mortality ensuing incident stroke in patients with and without psychotic disorders. This intuitive result may be explained by some studies which demonstrated that schizophrenic stroke patients were less likely to receive reperfusion treatments and prophylactic medications. The absence of data on lifestyle factors, antipsychotic treatment and post-stroke management is a major limitation in our study. In conclusion, our results indicated that schizophrenia is associated with increased short-term mortality after incident ischemic stroke. Further research is warranted to clarify the contribution of possible risk factors to post-stroke mortality in schizophrenia patients.

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