title: The impact of smoking on the severity of acute ischemic stroke.
abstract: OBJECTIVE
  This study investigated the impact of smoking on the initial severity of acute ischemic stroke and examined its subsequent outcome.
  
  
  METHODS
  Patient data was collected from the Stroke Registry in the Chang Gung Healthcare System (SRICHS). A total of 2650 patients admitted for acute ischemic stroke from January to December 2009 were included. Baseline characteristics were compared between smokers and non-smokers. Factors affecting the initial severity and the recovery from neurological deficit were examined by logistic regression analysis. The patients were further divided according to stroke mechanism for subgroup analysis.
  
  
  RESULTS
  The total number of smokers and non-smokers was 817 (31.9%) and 1833 (69.1%), respectively. Univariate analysis showed that smokers had lower NIHSS scores on admission than did non-smokers (P<0.001). In subgroup analysis, smokers with small-vessel occlusions frequently had higher NIHSS scores on admission than did non-smokers (P=0.001). However, smokers with cardioembolic stroke had lower NIHSS scores on admission as compared to non-smokers (P=0.024). No subgroup had smoking as a significant factor for neurological recovery during hospitalization.
  
  
  CONCLUSIONS
  Smoking correlated with higher NIHSS scores on admission for small-vessel occlusion. Conversely, it was associated with lower NIHSS scores on admission for cardioembolism.
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung branch, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Weng
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Huang
authors.forename: Yu-Yi
authors.initials: YY
authors.lastname: Chien
authors.forename: Chia-Lun
authors.initials: CL
authors.lastname: Wu
authors.forename: Feng-Chieh
authors.initials: FC
authors.lastname: Su
authors.forename: Heng Jung
authors.initials: HJ
authors.lastname: Hsu
authors.forename: Tsong-Hai
authors.initials: TH
authors.lastname: Lee
authors.forename: Tsung-I
authors.initials: TI
authors.lastname: Peng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*