Table of Contents
International Scholarly Research Notices
Volume 2014, Article ID 904647, 8 pages
http://dx.doi.org/10.1155/2014/904647
Research Article

Outcome Predictors in First-Ever Ischemic Stroke Patients: A Population-Based Study

1Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy
2Statistics Department, Ospedale Regionale, Viale Ginevra 3, 11100 Aosta, Italy
3Department of Scienze della Sanità Pubblica, Università degli Studi di Torino, Via Verdi 8, 10124 Torino, Italy

Received 31 May 2014; Accepted 14 November 2014; Published 25 December 2014

Academic Editor: Adriá Arboix Damut

Copyright © 2014 Giovanni Corso et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. There is scant population-based information regarding predictors of stroke severity and long-term mortality for first-ever ischemic strokes. The aims of this study were to determine the characteristics of patients who initially presented with first-ever ischemic stroke and to identify predictors of severity and long-term mortality. Methods. Data were collected from the population-based Cerebrovascular Aosta Registry. Between 2004 and 2008, 1057 patients with first-ever ischemic stroke were included. Variables analysed included comorbidities, sociodemographic factors, prior-to-stroke risk factors, therapy at admission and pathophysiologic and metabolic factors. Multivariate logistic regression models, Kaplan-Meier estimates, and Cox proportional Hazards model were used to assess predictors. Results. Predictors of stroke severity at admission were very old age (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.75–5.06), female gender (OR 1.73, 95% CI 1.21–2.40), atrial fibrillation (OR 2.76, 95% CI 1.72–4.44), low ejection fraction (OR 2.22, CI 95% 1.13–4.32), and cardioembolism (OR 2.0, 95% CI 1.36–2.93). Predictors of long-term mortality were very old age (hazard ratio [HR] 2.02, 95% CI 1.65–2.47), prestroke modified Rankin scale 3–5 (HR 1.82; 95% CI 1.46–2.26), Charlson Index 2 (HR 1.97; 95% CI 1.62–2.42), atrial fibrillation (HR 1.43, 95% CI 1.04–1.98), and stroke severity (HR 3.54, 95% CI 2.87–4.36). Conclusions. Very old age and cardiac embolism risk factors are the independent predictors of stroke severity. Moreover, these factors associated with other comorbid medical conditions influence independently long-term mortality after ischemic stroke.