Prognostic significance of smoking in patients with acute ischemic stroke within 3 months of onset.
BACKGROUND
Various factors that have been implicated in recovery after the acute phase of stroke have not been well evaluated.


METHODS
To identify prognostic factors affecting outcomes at 90 days after stroke from the viewpoint of recovery patterns, we enrolled 660 patients from the Edaravone and Argatroban Stroke Therapy for Acute Ischemic Stroke study database. Fourteen groups of patients were identified based on an analysis of their recovery patterns according to changes in their National Institutes of Health Stroke Scale scores during the first 21 days. These groups were then divided into 2 groups: favorable recovery trend (patterns 1-3; n = 486) and poor recovery trend (patterns 4-14; n = 174). Patterns with >80% of the patients experiencing a favorable outcome (National Institutes of Health Stroke Scale score of ≤ 4 at 90 days) were defined as the favorable recovery trend group, whereas patterns that included ≤ 80% favorable outcomes were defined as the poor recovery trend group.


RESULTS
Using the poor recovery trend group, logistic regression analysis found that after controlling for covariates, lower scores at admission, fewer ischemic lesions, and nonsmoking were significant prognostic factors for a favorable outcome at 90 days.


CONCLUSIONS
Based on a detailed analysis of the relationship between recovery patterns after stroke and clinical outcomes in the chronic stage of stroke, smoking cessation may improve the prognosis of patients after stroke.
Center of Medical Information Science, Kochi University Medical School, Nankoku, Japan. kumagain@kochi-u.ac.jp
Naoko
N
Kumagai
Hideki
H
Origasa
Takehiko
T
Nagao
Hidehiro
H
Takekawa
Yoshiyasu
Y
Okuhara
Takenori
T
Yamaguchi
D000368:Aged; D000369:Aged, 80 and over; D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D000077553:Edaravone; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010875:Pipecolic Acids / Q000627:therapeutic use*; D020127:Recovery of Function; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D013449:Sulfonamides; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010875:Pipecolic Acids; D013449:Sulfonamides; D001120:Arginine; C031942:argatroban; D000077553:Edaravone; D000983:Antipyrine