title: [Recurrent ischemic stroke. Study of 605 patients].
abstract: OBJECTIVE
  To characterize the clinical factors and prognosis and identify determinants of ischemic stroke recurrence in acute stroke.
  
  
  METHODS
  Recurrent stroke patterns were studied in 605 consecutive patients admitted with a second or further ischemic stroke to the Department of Neurology of the Sagrat Cor Hospital of Barcelona over a 17 year period. Demographic, risk factors, clinical, neuroimaging and outcome variables were analyzed and compared with patients with first-ever cerebral infarction (n=2.099) to identify predictors of ischemic recurrent stroke. Significant variables were entered into a multivariate logistic regression analysis.
  
  
  RESULTS
  Ischemic recurrent strokes accounted for 22.4% of all acute consecutive ischemic strokes. Frequency of ischemic stroke recurrence were significantly different among ischemic stroke subtypes: 26.2% in atherothrombotic, 24.4% in cardioembolic, 21.8% in lacunar stroke, 15.8% in infarcts of unusual etiology and 12% infarctions of uncertain etiology. The overall in-hospital mortality and symptom free at discharge in recurrent vs. non-recurrent stroke patients rate was 16.2 vs. 12% (p=0.005) and 17.8 vs. 27.3% (p=0.0001) respectively. Previous intracerebral hemorrhage (OR=3.07; 95% CI, 1.51-6.25), intermittent claudication (OR=1.39; 95% CI, 1.01-1.90), arterial hypertension (OR=1.32; 95% CI, 1.09-1.59), diabetes mellitus (OR=1.26; 95% CI, 1.02-1.56), age (OR=1.02; 95% CI, 1.01-1.03), female gender (OR=0.63; 95% CI, 0.52-0.77), headache (OR=0.62; 95% CI, 0.44-0.87) and bulbar topography (OR=0.21; 95% CI, 0.05-0.89) were independent clinical variables related to ischemic stroke recurrence.
  
  
  CONCLUSIONS
  About one in every four patients with ischemic stroke had an ischemic stroke recurrence. In-hospital mortality is 16.2% and clinical profiles were different in ischemic stroke recurrence when compared to first-ever ischemic stroke patients.
authors.affiliation: Unidad de Enfermedades Vasculares Cerebrales, Servicio de Neurología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, España. aarboix@hscor.com
authors.forename: Adrià
authors.initials: A
authors.lastname: Arboix
authors.forename: Joan
authors.initials: J
authors.lastname: Massons
authors.forename: Luís
authors.initials: L
authors.lastname: García-Eroles
authors.forename: Emili
authors.initials: E
authors.lastname: Comes
authors.forename: Miquel
authors.initials: M
authors.lastname: Balcells
authors.forename: Montserrat
authors.initials: M
authors.lastname: Oliveres
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology; D002545:Brain Ischemia / Q000453:epidemiology*; D002544:Cerebral Infarction / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007383:Intermittent Claudication / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome