scholarly journals Clinical risk factors associated with recurrence of ischemic stroke within two years

Medicine ◽  
2020 ◽  
Vol 99 (26) ◽  
pp. e20830
Author(s):  
Yuanyuan Zhuo ◽  
Jiaman Wu ◽  
Yimin Qu ◽  
Haibo Yu ◽  
Xingxian Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Clinical Risk Factors ◽  
Factors Associated ◽  
Clinical Risk

scholarly journals Cholesterol reducer and Thrombolytic therapy in acute ischemic stroke

2020 ◽  
Author(s):  
Nicolas Poupore ◽  
Dan Strat ◽  
Tristan Mackey ◽  
Katherine Brown ◽  
Ashley Snell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Demographic Data ◽  
Recombinant Tissue Plasminogen Activator ◽  
Clinical Risk Factors ◽  
Medication History ◽  
Factors Associated ◽  
Clinical Risk

Abstract Background Specific clinical risk factors may contribute to worsening or improving neurological functions in an acute ischemic stroke (AIS) patient pre-treated with a cholesterol reducer with a subsequent recombinant tissue plasminogen activator (rtPA) treatment. We investigated clinical risk factors associated with good or poor presenting neurological symptoms in ischemic stroke patients with prior cholesterol reducer use, specifically a statin and rtPA therapy.Methods We retrospectively analyzed baseline clinical and demographic data of 630 patients with AIS taking cholesterol reducers prior to rtPA treatment from January 2010 to June 2016 in a regional stroke center. Progressing (NIHSS ≤ 7) or worsening (NIHSS > 7) scores for neurologic improvement determined measures for treatment outcome. Multivariate logistic regression models identified demographic and clinical factors associated with worsening or progressing neurologic functions.Results Adjusted multivariate analysis showed that in an ischemic stroke population with a combined rtPA and cholesterol reducer medication history, increasing age (OR = 1.032, 95% CI, 1.015-1.048, P < 0.001) and atrial fibrillation (OR = 1.859, 95% CI, 1.098-3.149, P = 0.021) demonstrated a likely association with worsening neurologic functions, while direct admission (OR = 0.411, 95% CI, 0.246-0.686, P = 0.001) and being Caucasian (OR = 0.496, 95% CI, 0.297-0.827, P = 0.007) showed an association with improving or progressing neurologic functions.Conclusion A prior cholesterol reducer, namely a statin, plus rtPA combination may be associated with worsening neurological function for elderly AIS patients with atrial fibrillation, while Caucasians directly admitted to a neurology unit are more likely to show an association with progress or improvements in neurologic functions.

Abstract 1122‐000161: Clinical Factors Associated with rtPA Inclusion in Ischemic Stroke Patients with and without Heart Failure

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Carolyn B Sanders ◽  
Camron Edrissi ◽  
Chase Rathfoot ◽  
Krista Knisely ◽  
Nicolas Poupore ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ischemic Stroke ◽  
Coronary Artery ◽  
Clinical Risk Factors ◽  
Clinical Factors ◽  
Factors Associated ◽  
Clinical Risk ◽  
Direct Admission ◽  
Stroke Center

Introduction : It is estimated that approximately 10–24% of acute ischemic stroke (AIS) patients have comorbid heart failure (HF). However, it is currently unknown if certain clinical risk factors associated with rtPA thrombolytic therapy differ based on HF diagnosis. The purpose of this study is to determine the clinical factors associated with rtPA inclusion in AIS patients with and without heart failure. Methods : Retrospective data for baseline clinical and demographic factors from January 2010 to January 2016 in a regional stroke center were analyzed. Of the 5,469 patients identified with AIS, 590 presented with heart failure while 4,879 did not. Odds ratios and 95% confidence intervals were used to determine which clinical factors were associated with rtPA inclusion. Results : Adjusted multivariate analysis demonstrated that within the AIS population, those without HF who received rtPA were more likely to be associated with Hispanic ethnicity (OR = 0.464, 95% CI, 0.247‐0.87, P = 0.017), coronary artery stenosis (OR = 0.55, 95% CI, 0.366‐0.83, P = 0.004), previous stroke (OR = 0.745, 95% CI, 0.609‐0.91, P = 0.004), previous TIA (OR = 1.447, 95% CI, 1.094‐1.91, P = 0.010), total cholesterol (OR = 1.487, 95% CI, 1.175‐1.88, P = 0.001), lipids (OR = 0.998, 95% CI, 0.996‐1, P = 0.038), serum creatinine (OR = 0.899, 95% CI, 0.854‐0.95, P<0.001), INR (OR = 0.825, 95% CI, 0.73‐0.93, P = 0.002), heart rate (OR = 0.13, 95% CI, 0.071‐0.24, P<0.001), and direct admission (OR = 2.87, 95% CI, 2.432‐3.39, P<0.001). AIS patients with HF who received rtPA were more likely to be associated with increasing age (OR = 0.982, 95% CI, 0.966‐1, P = 0.020), coronary artery disease (OR = 0.618, 95% CI, 0.391‐0.98, P = 0.0.040), INR (OR = 0.326, 95% CI, 0.129‐0.82, P = 0.018), and ambulatory improvement (OR = 1.69, 95% CI, 1.058‐2.7, P = 0.0.028). Conclusions : The results of this study demonstrate that within the AIS population, there are certain clinical risk factors that influence the likelihood of receiving rtPA in patients with and without HF. These findings provide further insight into AIS and HF and suggest the need for further research into the role the identified factors play in influencing clinical outcome.

scholarly journals Cholesterol reducer and thrombolytic therapy in acute ischemic stroke patients

2020 ◽  
Author(s):  
Nicolas Poupore ◽  
Dan Strat ◽  
Tristan Mackey ◽  
Katherine Brown ◽  
Ashley Snell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Demographic Data ◽  
Clinical Risk Factors ◽  
Stroke Patients ◽  
Medication History ◽  
Factors Associated ◽  
Clinical Risk

Abstract Background Specific clinical risk factors may contribute to worsening or improving neurological functions in an acute ischemic stroke (AIS) patient pre-treated with a cholesterol reducer with a subsequent recombinant tissue plasminogen activator (rtPA) treatment. We investigated clinical risk factors associated with good or poor presenting neurological symptoms in ischemic stroke patients with prior cholesterol reducer use, specifically a statin and rtPA therapy. Methods We retrospectively analyzed baseline clinical and demographic data of 630 patients with AIS taking cholesterol reducers prior to rtPA treatment from January 2010 to June 2016 in a regional stroke center. Progressing (NIHSS ≤ 7) or worsening (NIHSS > 7) scores for neurologic improvement determined measures for treatment outcome. Multivariate logistic regression models identified demographic and clinical factors associated with worsening or progressing neurologic functions. Results Adjusted multivariate analysis showed that in an ischemic stroke population with a combined rtPA and cholesterol reducer medication history, increasing age (OR = 1.032, 95% CI, 1.015-1.048, P < 0.001) and atrial fibrillation (OR = 1.859, 95% CI, 1.098-3.149, P = 0.021) demonstrated a likely association with worsening neurologic functions, while direct admission (OR = 0.411, 95% CI, 0.246-0.686, P = 0.001) and being Caucasian (OR = 0.496, 95% CI, 0.297-0.827, P = 0.007) showed an association with improving or progressing neurologic functions. Conclusion A prior cholesterol reducer, namely a statin, plus rtPA combination may be associated with worsening neurological function for elderly AIS patients with atrial fibrillation, while Caucasians directly admitted to a neurology unit are more likely to show an association with progress or improvements in neurologic functions.

scholarly journals Ischemic stroke with a preceding Trans ischemic attack(TIA) less than 24 hours: Predicting clinical risk factors for thrombolytic therapy

2019 ◽  
Author(s):  
Nicolas Poupore ◽  
Dan Strat ◽  
Tristan Mackey ◽  
Ashley Snell ◽  
Thomas Nathaniel
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Older Patients ◽  
Clinical Risk Factors ◽  
Receiver Operating Curve ◽  
Stroke Patients ◽  
Clinical Risk ◽  
Stroke Population ◽  
Clinical Risks

Abstract Background Acute ischemic stroke attack with and without a recent TIA within or less than 24 hours may differ in clinical risk factors, and this may affect treatment outcomes following thrombolytic therapy. We examined whether the odds of exclusion or inclusion for thrombolytic therapy are greater in ischemic stroke with TIA less than 24 hours preceding ischemic stroke(TIA-24hr-ischemic stroke patients) as compared to those without recent TIA or non-TIA <24 hours.Methods A retrospective hospital-based analysis was conducted on 6,315 ischemic stroke patients, of whom 846 had proven brain diffusion-weighted magnetic resonance imaging (DW-MRI) of an antecedent TIA within 24 hours prior to ischemic stroke. The logistic regression model was developed to generate odds ratios (OR) to determine clinical factors that may increase the likelihood of exclusion or inclusion for thrombolytic therapy. The validity of the model was tested using a Hosmer-Lemeshow test, while the Receiver Operating Curve (ROC) was used to test the sensitivity of our model.Results In TIA-24hr-ischemic stroke population, patients with a history of alcohol abuse (OR = 5.525, 95% CI, 1.003-30.434, p = 0.05), migraine (OR=4.277, 95% CI, 1.095-16.703, p=0.037), and increasing NIHSS score (OR=1.156, 95% CI, 1.058-1.263, p = 0.001) were associated with the increasing odds of receiving rtPA, while older patients (OR = 0.965, 95% CI, 0.934‐0.997, P = 0.033) were associated with the increasing odds of not receiving rtPA.Conclusion In TIA-24hr-ischemic stroke patients, older patients with higher INR values are associated with increasing odds of exclusion from thrombolytic therapy. Our findings demonstrate clinical risks factors that can be targeted to improve the use and eligibility for rtPA in in TIA-24hr-ischemic stroke patients.

scholarly journals Clinical Risk Factors Associated with Mortality Among Burn Patients Admitted to Jinnah Burn and Reconstructive Surgery Center, Lahore

2020 ◽  
Vol 34 (3) ◽  
pp. 46-50
Author(s):  
Fatima Sakhawat
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Reconstructive Surgery ◽  
Low Income ◽  
Burn Injuries ◽  
Clinical Risk Factors ◽  
Burn Patients ◽  
Factors Associated ◽  
Clinical Risk ◽  
Surgery Center

Introduction: Burn injuries being highly devastating in nature, are associated with extensive morbidity and mortality. Although the incidence of burn injuries is less in developed countries but it is increasing in developing and low income countries. Aims & Objectives: The aim of this study was to determine clinical risk factors associated with mortality among burn patients. Place and duration of study: Jinnah Burn and Reconstructive Surgery Center, Lahore from August 2018 till January 2019. Material & Methods: Data was collected by researchers themselves by studying files of patients. Data analysis was done by using SPSS and Pearson Chi Square test was used to determine association of clinical risk factors with mortality among burn patients. Results: Out of 200 patients, 137 were males. The Mortality rate was 12.50 %. Cardiopulmonary arrest was the most common cause of death. Sepsis was the most common complication among burn patients. Higher mortality rates were observed among patients with arterial/venous and urinary catheterization done. Higher survival rates were seen in those patients who were treated with debridement, grafting surgeries, Colistin Use and aided by mechanical ventilation. Conclusion: Aid through mechanical ventilation, grafting surgeries, wound debridement, use of colistin are associated with improved survival outcomes among burn patients. Whereas inhalational injury, arterial/venous catheterization, urinary catheter and sepsis are seen as major predictors of mortality among burn patients

scholarly journals Can clinical risk factors predict functional recovery in ischemic stroke patients with pre-stroke depression?

2019 ◽  
Author(s):  
Leah Wormack ◽  
Brice Blum ◽  
Benjamin Bailes ◽  
Thomas Nathaniel
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Functional Outcome ◽  
Clinical Risk Factors ◽  
Stroke Patients ◽  
Antihypertensive Medications ◽  
Clinical Risk ◽  
Predictive Variables ◽  
Stroke Population ◽  
Thrombolysis Therapy

Abstract Background. Specific clinical risk factors that may be associated with ambulatory outcome following thrombolysis therapy in ischemic stroke patients with pre-stroke depression is not fully understood. This was investigated. Methods. Multivariate analyses were performed to identify predictors of functional ambulatory outcomes. Patient demographics and clinical risk factors served as predictive variables, while improvement or no improvement in ambulatory outcome was considered as the primary outcome. Results. A total of 595 of these patients received rtPA of which 310 patients presented with pre-stroke depression, 217 had no improvement in functional outcome, while 93 patients presented with an improvement in functional outcome. Carotid artery stenosis (OR= 11.577, 95% CI, 1.281 – 104.636, P=0.029) and peripheral vascular disease (OR= 18.040, 95% CI, 2.956-110.086, P=0.002) were more likely to be associated with an improvement in ambulation. Antihypertensive medications (OR= 7.810, 95% CI, 1.401 –43.529, P=0.019),previous TIA (OR= 0.444, 95% CI, 0.517 –0.971, P=0.012), and congestive heart failure (OR= 0.217, 95% CI, 0.318 –0.402, P=0.030) were associated with a no improvement in ambulation. Conclusion. After adjustment for covariates, more clinical risk factors were associated with no improvement when compared with improvement in functional outcome following thrombolysis therapy in an acute ischemic stroke population with pre-stroke depression.

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