Predicting spontaneous early neurological recovery after acute ischemic stroke.
We assessed predictors of spontaneous early neurological recovery after acute ischemic stroke by means of multivariate analysis in a cohort of 1,473 consecutive patients treated at one academic center. At hospital discharge, spontaneous neurological improvement or good outcome was defined as grades 0-2 of the Rankin scale, and poor outcome (no improvement or in-hospital death) as grades 3-5. Spontaneous recovery of neurological deficit at the time of discharge from the hospital was observed in 16% of patients with cerebral infarction (n = 238). Dysarthria-clumsy hand syndrome improved in 44% of patients and was the only variable significantly associated with in-hospital functional recovery in three logistic regression models that in addition to lacunar syndromes, included demographic variables, cardiovascular risk factors, and clinical variables [odds ratio (OR) 2.56], neuroimaging findings (OR 2.48), and outcome data (OR 2.39), respectively. Clinical factors related to severity of infarction available at stroke onset have a predominant influence upon in-hospital outcome and may help clinicians to assess prognosis more accurately. Our work gives a contribution into prognostic factors after acute ischemic stroke. With regard to patterns of stroke, dysarthria-clumsy hand syndrome was a significant predictor of spontaneous in-hospital recovery in ischemic stroke patients.
Arboix
Adrià
A
Acute Stroke Unit, Service of Neurology, Hospital del Sagrat Cor, Barcelona, Spain. aarboixd@meditex.es
García-Eroles
Lluis
L
Comes
Emili
E
Oliveres
Montserrat
M
Balcells
Miquel
M
Pacheco
Gustavo
G
Targa
Cecilia
C
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000145:classification / Q000150:complications* / Q000175:diagnosis; D015331:Cohort Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome