Impact of comorbidity on ischemic stroke outcome.
OBJECTIVE
To evaluate the impact of comorbidity on stroke outcome of patients admitted to a general ward (GW) and a stroke unit (SU).


METHODS
Data of 266 patients with acute ischemic stroke (GW: 103, SU: 163) were collected prospectively for 13 months. Clinical and radiological findings, and the Charlson Comorbidity Index (CCI) were recorded. Predictors of outcome 4 months after stroke were analyzed. Favorable outcome was defined as modified Rankin Scale (mRS) score of < or = 2, unfavorable as mRS >2.


RESULTS
The mean age of the patients was 67.2 years (SD = 14.4), the mean CCI 1.2 (SD = 1.4). In univariate analysis, small artery disease predicted favorable outcome (P < 0.001) and age (P = 0.022), high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001), high CCI (P < 0.001), treatment in a GW (P = 0.004), coronary artery disease (P = 0.02), dementia (P = 0.009), diabetes (P = 0.005) and atrial fibrillation (P < 0.001) unfavorable outcome after 4 months. In multivariate analysis, high NIHSS score (P < 0.001), atrial fibrillation (P = 0.004), coronary artery disease (P = 0.012) and diabetes (P = 0.031) were predictors of unfavorable outcome.


CONCLUSIONS
Comorbidity has a significant impact on stroke outcome. In addition to stroke severity, atrial fibrillation, coronary artery disease and diabetes were predictors of outcome after stroke, but not the sum of the CCI.
Fischer
U
U
Neurology Department, University Hospital, Bern, Switzerland.
Arnold
M
M
Nedeltchev
K
K
Schoenenberger
R A
RA
Kappeler
L
L
Höllinger
P
P
Schroth
G
G
Ballinari
P
P
Mattle
H P
HP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006757:Hospital Units; D006769:Hospitals, General; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010362:Patients' Rooms; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome