Preadmission Use of Warfarin Improves Short-Term Outcome in Patients with Acute Cerebral Infarction

Purpose: We studied the association between admission white blood cell (WBC) count and short term outcome in patients with acute cerebral infarction. Methods: 2808 patients with acute cerebral infarction were included in the study. WBC count and other variables were collected within the first 24 hours of admission. Clinical outcomes (death or dependency) were evaluated by neurologists during hospitalization. The associations between WBC count and in-hospital death or dependency at discharge were analyzed using a multiple logistic model. Result: Multivariate-adjusted odds ratio (95% confidence intervals) of dependency associated with patients with WBC of 10.0-10.9×109/L, 11.0-11.9×109/L, ≥12.0×109/L were 1.46(0. 87-2. 45), 6.21(3. 70-10. 42) and 7.01(4. 53-10. 87), respectively, when compared with patients with admission WBC counts < 10.0x109/L. Multivariate-adjusted odds ratio (95% confidence intervals) of death associated with WBC 10.0-10.9×109/L, 11.0-11.9×109/L and ≥12.0×109/L were 2.098(0. 96-4. 58), 4.79(2. 24-10. 22) and 5.59(3. 14-9. 98), respectively. Conclusion: Increased WBC count at admission was significantly and positively associated with in-hospital death or dependency at discharge among patients with acute cerebral infarction.

Download Full-text

Persistent Atrial Fibrillation Is Associated with Worse Prognosis Than Paroxysmal Atrial Fibrillation in Acute Cerebral Infarction

ISRN Cardiology ◽

10.5402/2012/650915 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Halvor Naess ◽

Ulrike Waje-Andreassen ◽

Lars Thomassen

Keyword(s):

Atrial Fibrillation ◽

Cerebral Infarction ◽

Persistent Atrial Fibrillation ◽

Stroke Onset ◽

Acute Cerebral Infarction ◽

Short Term ◽

Term Outcome ◽

Nihss Score ◽

Short Term Outcome ◽

Clot Structure

Background and Purpose. We hypothesized that patients with persistent atrial fibrillation (AF) suffer from more severe cerebral infarction than patients with paroxysmal AF due to differences in clot structure and volume. Methods. This study includes consecutive patients with acute cerebral infarction and persistent or paroxysmal AF documented by ECG any time prior to stroke onset. The National Institute of Health Stroke Scale (NIHSS) was used to assess stroke severity on admission. Short-term outcome was determined by the modified Rankin scale (mRS) score, Barthel index, and NIHSS score 7 days after stroke onset. Risk factors were registered on admission. Eligible patients were treated with thrombolysis. Results. In total, 141 (52%) patients had paroxysmal AF, and 129 (48%) patients had persistent AF. NIHSS score on admission, mRS score at day 7, and mortality were significantly higher among patients with persistent AF. Thrombolysis was less effective in patients with persistent AF. Conclusions. Our study shows that patients with persistent AF and acute cerebral infarction have poorer short-term outcome than patients with paroxysmal AF. Differences in clot structure or clot volume may explain this.

Download Full-text