title: Speech disturbance at stroke onset is correlated with stroke early mortality.
abstract: BACKGROUND
  Speech disturbance is a common symptom of stroke and is important as a prompt identifier of the event. The frequency of the symptom among each stroke subtype, differences between patients with and without speech disturbance and its correlation to early mortality remain unclear.
  
  
  METHODS
  The Kyoto prefecture of Japan has established a registry to enroll new stroke patients in cooperation with the Kyoto Medical Association and its affiliated hospitals. It is named the Kyoto Stroke Registry (KSR). We confirmed the existence or absence of speech disturbance in 1693 stroke patients registered to the KSR and investigated associations between speech disturbance and other characteristics.
  
  
  RESULTS
  Speech disturbance was observed in 52.6% of cerebral infarction (CI), 47.5% of cerebral hemorrhage (CH), and 8.0% of subarachnoid hemorrhage (SAH) cases. Characteristics showing statistically significant differences between patients with and without speech disturbance and patients were age, blood pressure, history of hypertension, arrhythmia and diabetes mellitus, habit of tobacco and alcohol, and paresis. Mortality rates of patients with/without speech disturbance were 5.2%/1.2% for CI, 12.5% /4.1% for CH, and 62.5%/ 9.0% for SAH. Adjusted hazard ratios were 2.63 (1.14-6.13, p = 0.024) in CI, 4.15 (1.41-12.23, p = 0.010) in CH, and 20.46 (4.40-95.07, p < 0.001) in SAH).
  
  
  CONCLUSIONS
  Speech disturbance was frequently observed in stroke patients at the onset and therefore could be useful to identify the problem at the earliest stage. Hazard ratio for death was higher in stroke patients with speech disturbance than patients without. Speech disturbance is a prompt predictor of stroke early mortality.Hiromi Nakano, Yoshiyuki Watanabe, Tatsuyuki Sekimoto, Kouichiro Shimizu, Akihiko Nishizawa, Atsushi Okumura and Masahiro Makino contributed equally to this work.
authors.affiliation: Department of Neurology, National Hospital Organization, Minami Kyoto Hospital, Kyoto, Japan. neuron.k07@gmail.com
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nakano
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Sekimoto
authors.forename: Kouichiro
authors.initials: K
authors.lastname: Shimizu
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nishizawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okumura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Makino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000209:etiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013064:Speech Disorders / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D020521:Stroke / Q000150:complications* / Q000401:mortality*