title: Factors associated with early outcome in patients with large-vessel carotid strokes.
abstract: OBJECTIVE
  To describe the severity and early neurological deterioration (END) in patients with symptomatic carotid stenosis and to analyse the influence of related factors.
  
  
  METHODS
  Observational cohort study of patients with ischaemic stroke, ipsilateral carotid stenosis and without evidence of cardiac sources of embolism prospectively recorded since January 2003 to January 2012. Initial severity was categorised as mild (NIH stroke scale (NIHSS) ≤7), moderate (NIHSS 8-14) or high (NIHSS >14). Logistic ordinal and regression analyses were performed for stroke severity and END risk.
  
  
  RESULTS
  Of 2332 ischaemic strokes attended, 338 patients were included. Stroke severity was mild in 254 (75.1%) cases, moderate in 53 (15.7%) and severe in 31 (9.2%). Adjusted ORs (95% CI) for stroke severity were: degree of carotid stenosis, 2.20 (1.55 to 3.11, p<0.001); intracranial disease, 1.93 (1.18 to 3.17, p=0.009); plasma glucose, 1.01 (1.003 to 1.02, p<0.001); and previous transient ischaemic attack (TIA), 0.37 (0.17 to 0.82, p=0.014). 78 patients (23.1%) had END. Multivariate analysis showed independent association between END and degree of carotid stenosis (OR 1.64, 1.14 to 2.34, p=0.007), previous TIA (OR 2.40, 1.25 to 4.57, p=0.008) and mean arterial pressure (OR 1.02, 1.01 to 1.04, p=0.003).
  
  
  CONCLUSIONS
  Strokes due to large vessel disease in the carotid artery are in general of mild severity and have a high rate of END. The degree of stenosis has a clear association with higher severity and END risk.
authors.affiliation: Neurology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain. Ecuadrado@hospitaldelmar.cat
authors.forename: Elisa
authors.initials: E
authors.lastname: Cuadrado-Godia
authors.forename: Sara
authors.initials: S
authors.lastname: Jimena
authors.forename: Angel
authors.initials: A
authors.lastname: Ois
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Campello
authors.forename: Eva
authors.initials: E
authors.lastname: Giralt-Steinhauer
authors.forename: Carol
authors.initials: C
authors.lastname: Soriano-Tarraga
authors.forename: Jordi
authors.initials: J
authors.lastname: Jiménez-Conde
authors.forename: José Enrique
authors.initials: JE
authors.lastname: Martínez-Rodríguez
authors.forename: Jaume
authors.initials: J
authors.lastname: Capellades
authors.forename: Jaume
authors.initials: J
authors.lastname: Roquer
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis*