title: Risk factors and outcome of subtypes of ischemic stroke. Data from a multicenter multinational hospital-based registry. The European Community Stroke Project.
abstract: BACKGROUND
  Information on determinants and prognosis of ischemic stroke subtypes is scarce. We aimed at evaluating risk factors, pathogenesis, treatment and outcome of different ischemic stroke subtypes.
  
  
  METHODS
  In a European Concerted Action involving seven countries, ischemic stroke subtypes defined according to the Oxfordshire Community Stroke Project (OCSP) were evaluated for demographics, baseline risk factors, resource use, 3-month survival, disability (Barthel Index) and handicap (Rankin Scale).
  
  
  RESULTS
  During the 12-month study period, cerebral infarction was diagnosed in 2740 patients with first-in-a-lifetime stroke (mean age 70.5+/-12.4 years, 53.4% males). OCSP classification was achieved in 2472 (90.2%). Of these, 26.7% were total anterior circulation infarctions (TACI), 29.9% partial anterior circulation infarctions (PACI), 16.7% posterior circulation infarctions (POCI) and 26.7% lacunar infarctions (LACI). In multivariate analysis, atrial fibrillation was predictive of TACI (odds ratio [OR], 1.61; 95% CI, 1.28-2.03), hypertension (OR, 1.38; 95% CI, 1.16-1.65) and myocardial infarction (OR, 1.42; 95% CI, 1.08-1.86) predictive of PACI, hypertension (OR, 1.25; 95% CI, 1.04-1.50) predictive of LACI. A negative association was observed between TACI and hypertension (OR, 0.51; 95% CI, 0.42-0.61). Discharge home was 50% less probable in TACI and PACI than in LACI patients. As compared to LACI, TACI significantly increased the risk of 3-month death (OR, 5.73; 95% CI, 3.91-8.41), disability (OR, 3.27; 95% CI, 2.30-4.66) and handicap (OR, 2.71; 95% CI, 1.91-3.85).
  
  
  CONCLUSIONS
  Ischemic stroke subtypes have different risk factors profile, with consequences on pathogenesis and prognosis. Information on determinants of the clinical syndromes may impact on prevention and acute-phase interventions.
authors.affiliation: Institute of Neurosciences, ILSA Study, Italian National Research Council, Viale Morgagni 46/48, 50134 Florence, Italy. dicarlo@in.cnr.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Maria
authors.initials: M
authors.lastname: Lamassa
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pracucci
authors.forename: Domenico
authors.initials: D
authors.lastname: Consoli
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.forename: Anthony
authors.initials: A
authors.lastname: Rudd
authors.forename: Ilse
authors.initials: I
authors.lastname: Burger
authors.forename: Augusto
authors.initials: A
authors.lastname: Ghetti
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D014943:Global Health; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D016896:Treatment Outcome