PO04-MO-16 Estimation C-reactive protien (CRP) in acute ischemic stroke and correlation with risk factors: a case control study

2009 ◽  
Vol 285 ◽  
pp. S173-S174
Author(s):  
T.N. Dubey ◽  
V.K. Sharma ◽  
B.N. Gouda ◽  
R. Jain ◽  
H.P.S. Chandel
2015 ◽  
Vol 28 (5) ◽  
pp. 613 ◽  
Author(s):  
Ana Carrilho Romeiro ◽  
Anabela Valadas ◽  
José Marques

<p><strong>Introduction:</strong> It is still unclear whether the etiology of ischemic stroke differs between cancer and non-cancer patients. Stroke and cancer share common modifiable risk factors but evidence suggests that cancer patients have specific conditions that increase the risk of stroke. Our goal was to compare the etiology of ischemic stroke in cancer and non-cancer patients.<br /><strong>Material and Methods:</strong> Case-control study conducted in patients admitted to a stroke unit between January 2007 and December 2012. Cases had a concomitant diagnosis of cancer and acute ischemic stroke, controls of only stroke. Age, gender, vascular risk factors and etiology were compared between groups.<br /><strong>Results:</strong> Fifty-six cases were identified; 64.3% were men with a mean age of 71 years; 21 patients had evidence of active cancer. Gastrointestinal cancer (25.9%) was the most common; 151 controls were included matched for gender and age. Common modifiable vascular risk factors, between groups (cases versus controls) were not significantly different, except for diabetes mellitus, more frequent in the control group (16.1% vs 33.8%, p = 0.02). Previous thrombotic events were more frequent in the cancer cohort (8.9% vs 0.7%, p = 0.007). Other determined etiology subtype (TOAST classification) was more frequent in cancer patients when compared to controls (13.0% vs 0.8%, p &lt; 0.01), and a hypercoagulable state was significantly more prevalent in active cancer patients.<br /><strong>Discussion:</strong> In our case-control study two subsets of cancer patients were delineated. In a subgroup, cancer and stroke co-exist, sharing traditional vascular risk factors. In another subset of patients, stroke appears to be directly related to the presence of a malignancy, where hypercoagulopathy turns out to be a decisive mechanism.<br /><strong>Conclusion: </strong>In clinical grounds, hypercoagulopathy as stroke etiology should prompt the physician to screen the patient for occult cancer.</p>


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Ting Ye ◽  
Yi Dong ◽  
Shengyan Huang

Background: The dysphagia screening in acute ischemic stroke plays an important role in patients with risk of dysphagia. The aim of this hospital-based case-control study is to explore if V-VST, as a new nurse-driven dysphagia screening tool for AIS patients, might help to reduce the rate of post-stroke pneumonia and early withdraw of feeding tube. Methods: 1598 acute ischemic stroke patients were enrolled in this study. The standard protocol in AIS patients were assessed by WST (before intervention and plus with V-VST after intervention). The V-VST assessment were be trained in two senior nurses and all AIS patients were assessed by V-VST during July 1and Dec 30 th , 2017. Among 299 AIS patients with suspected, all clinical data were analyzed. The comparison of their rate of pneumonia in hospital and withdraw rate of tubefeeding before discharge were performed between patients post-intervention (January 1, 2018-June 30, 2019)and those admitted before the intervention (January 1, 2016-June 30, 2017). Results: The baseline characteristics of the pre- and post- intervention AIS groups were similar in age, gender, NIHSS. The implementation of V-VST have a statistically significant reducing the risk of pneumonia with an adjusted HR (0.60, 95% CI 0.43-0.84, P=0.003). Additionally, follow-up V-VST were likely to be associated the withdraw rate of tube-feeding at discharge (29/168 vs 38/131 P=0.016).There is also a trend of length of tube-feeding decreasing (8.32±12.27 vs 6.84±8.61 P=0.241). Conclusion: In our study, the V-VST is a feasible bedside tool. The implemental might be associated with the reduction of post-stroke pneumonia. Therefore, it meets the requirements of a clinical screening test for dysphagia in acute stroke patients at bedside. Large prospective interventional study is needed to confirm our findings. V-VST: Volume-viscosity Swallow Test WST: Water Swallow Test AIS: Acute Ischemic Stroke HR: hazard ratio


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nan Zhang ◽  
Lin Zhang ◽  
Qiu Wang ◽  
Jingwei Zhao ◽  
Jia Liu ◽  
...  

Abstract Background Globally, rates of ischemic stroke (IS) have been rising among young adults. This study was designed to identify risk factors associated with IS incidence in young adults unaffected by hypertension or diabetes. Methods This was a retrospective case-control study of early-onset IS patients without diabetes and hypertension. Control patients were matched with healthy individuals based upon sex, age (±2 years), and BMI (±3 kg/m2) at a 1:3 ratio. Sociodemographic, clinical, and risk factor-related data pertaining to these patients was collected. The association between these risk factors and IS incidence was then assessed using conditional logistic regression models. Results We recruited 60 IS patients and 180 controls with mean ages of 44.37 ± 4.68 and 44.31 ± 4.71 years, respectively, for this study. Relative to controls, IS patients had significantly higher total cholesterol (TG), homocysteine (HCY), white blood cell (WBC), absolute neutrophil count (ANC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels, and significantly lower high-density lipoprotein cholesterol (HDL-C) and triglyceride cholesterol (TC), free triiodothyronine (FT3), and free thyroxine (FT4) levels (all P < 0.05). After controlling for potential confounding factors, HCY and ANC were found to be significantly positively associated with IS incidence (OR 1.518, 95%CI 1.165–1.977, P = 0.002 and OR 2.418, 95%CI 1.061–5.511, P = 0.036, respectively), whereas HDL-C and FT3 levels were negatively correlated with IS incidence (OR 0.001, 95%CI 0.000–0.083, P = 0.003 and OR 0.053, 95%CI 0.008–0.326, P = 0.002, respectively). Conclusions In young non-diabetic and non-hypertensive patients, lower HDL-C and FT3 levels and higher HCY and ANC levels may be associated with an elevated risk of IS. Additional prospective studies of large patient cohorts will be essential to validate these findings.


Stroke ◽  
1993 ◽  
Vol 24 (2) ◽  
pp. 224-227 ◽  
Author(s):  
S A Mayer ◽  
R L Sacco ◽  
A Hurlet-Jensen ◽  
T Shi ◽  
J P Mohr

2013 ◽  
Vol 12 (3) ◽  
pp. 37-43
Author(s):  
Md Shaheen Wadud ◽  
Aminur Rahman ◽  
Mohammad Selim Shahi ◽  
Uttam Kumar Saha ◽  
AK Takib Uddin Ahmed ◽  
...  

Background: Epidemiologic studies have reported that microalbuminuria is a risk factor for stroke in men and a limited case control study found that the highest quintile of microalbuminuria values was associated with 13 fold increased risk for stroke. The goal of this study is designed to determine its relationship to risk factors for ischemic stroke. Materials and Methods: It was a prospective observational study conducted in the Department of Neurology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh. Fifty consecutive patients with ischemic stroke with at least two risk factors who fulfilled the inclusion criteria of case were confirmed by CT or MRI. Equal number of controls same ages without stroke who had at least two risk factors were compared with the case group. The patients were assessed clinically with structured questionnaire including blood pressure, height and weight, and monitoring blood glucose and microalbuminuria. Results: Microalbuminuria was found 58.0% in patients with ischemic stroke. Patients who had diabetes mellitus will have 13.86 times the risk for developing microalbuminuria (p<0.05). Patients who had HTN will have 4.19 times the risk for developing microalbuminuria (p<0.05) and BMI (?23 kg/m2) will have 4.24 times the risk for developing microalbuminuria with (p<0.05). Whereas TIA, IHD, dyslipidemia, smoking and positive family history were not significantly (P>0.05) associated with microalbuminuria in patients with ischemic stroke. Conclusion: The findings of this study show that diabetes is the factor most closely associated with microalbuminuria followed by HTN and BMI?23 kg/m2 with statistically significance in patients with ischemic stroke. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 37-43


Author(s):  
J M Reid ◽  
S J Phillips ◽  
G J Gubitz ◽  
J Jarrett ◽  
C Christian ◽  
...  

Background:Randomized trials demonstrate that intravenous tissue plasminogen activator (tPA) improves outcome in acute ischemic stroke (AIS). To assess translation of this efficacy into effectiveness in routine clinical practice we performed a case-control study of tPA treatment for AIS in a single hospital.Methods:151 tPA-treated AIS patients (1996-2005) were matched 1:1 with blinding to outcome to controls from a prospective registry based on age, gender, pre-stroke Oxford handicap scale (OHS), stroke severity, and subtype. The outcomes were in-hospital death, symptomatic intracranial hemorrhage (SICH), length-of-stay (LOS), discharge OHS and long-term survival.Results:In-hospital mortality (23% vs. 24%) or long-term survival (median follow-up of 2 years) was not different between cases and controls (p=0.83). SICH occurred in 7.8% (95% CI 4.2-13.5%) of tPA-treated patients. Median LOS was non-significantly shorter for cases (13 [7-29] vs. 16 [8-32] days, p=0.14) but significantly shorter in tPA-treated vs. non-treated women (14 [7-28] vs. 20 [11-34] days, p=0.04). At discharge 6.6% (95% CI 1.1-12.0%) more tPA-treated patients than controls had no disability (OHS ≤1, p=0.02). However, there was no difference in discharge independence rates or proportion discharged home.Conclusion:We demonstrate minor improvements in early recovery after stroke with tPA but the impact is less dramatic than that reported in randomized trials. This may relate to timing of treatment and the type of patients treated.


2021 ◽  
pp. 194187442110277
Author(s):  
Emma M. Loebel ◽  
Mary Rojas ◽  
Danielle Wheelwright ◽  
Connor Mensching ◽  
Laura K. Stein

Background and Purpose: Risk of 30-day stroke readmission has been attributed to medical comorbidities, stroke severity, and hospitalization metrics. The leading etiologies appear to vary across institutions and remain a moving target. We hypothesized that patients with increased medical complexity have higher odds of 30-day readmission and the immediate time after discharge may be most vulnerable. We aimed to characterize patients with 30-day readmission after acute ischemic stroke (IS) and identify predictors of post-IS readmission. Methods: We performed a retrospective case-control study analyzing post-IS 30-day readmission between January 2016-December 2019 using data from Mount Sinai Hospital’s Get With The Guidelines database. We performed chi square analyses and multivariate adjusted logistic regression model including age, sex, coronary artery disease (CAD), renal insufficiency (RI), history of prior stroke or TIA, length of stay (LOS) > 7, and NIHSS ≥ 5. Results: 6.7% (n = 115) of 1,706 IS encounters had 30-day readmission. The 115 cases were compared to 1,591 controls without 30-day readmission. In our adjusted model, CAD (OR = 1.7, p = 0.01), history of prior stroke or TIA (OR = 1.6, p = 0.01), LOS >7 (OR = 1.7, p = 0.02), and NIHSS ≥ 5 (OR = 4.5, p < 0.001) predicted 30-day readmission. 65% (n = 75) of readmitted patients had readmission within 14 days post-discharge. Conclusions: Patients with post-IS 30-day readmission were more likely to have complex medical comorbidities and history of stroke or TIA compared to controls. Patients with more severe stroke and longer LOS may benefit from individualized transition of care plans and closer follow up during the vulnerable 30-day post-stroke period.


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