Impact of chronic inflammatory airway disease on stroke severity and long-term survival after ischemic stroke--a retrospective analysis.
BACKGROUND
Chronic inflammatory airway disease (CIAD) has emerged as independent risk factor for cardiovascular mortality and ischemic stroke but the impact of co-existing CIAD in patients with ischemic stroke is less clear.


METHODS
We retrospectively analyzed 1013 patients with acute ischemic stroke who were consecutively admitted to the Department of Neurology, Charité - Universitätsmedizin Berlin, Germany within one year. Mean follow-up was 80 months (IQR 32-85 months). Using multivariable regression models we analyzed the impact of CIAD (defined as chronic obstructive pulmonary disease or asthma bronchiale) on stroke severity and outcome.


RESULTS
Co-existing CIAD was evident in 7.1 % (n = 72) of all patients with acute ischemic stroke. Baseline characteristics of stroke patients with CIAD did not differ significantly from ischemic stroke patients without CIAD. Age (OR 1.17 [95 % CI 1.03-1.37] per decade), atrial fibrillation (OR 3.43 [95 % CI 2.47-4.78]) and coronary artery disease (OR 1.51 [95 % CI 1.07-2.14]) but not a history of CIAD (p = 0.30) were associated with severe stroke (NIHSS≥11) on hospital admission. Age (HR 1.70 [95 % CI 1.53-1.87] per decade), peripheral artery disease (HR 1.91 [95 % CI 1.35-2.7]), stroke severity at hospital admission (NIHSS per point HR 1.08 [95 % CI 1.06-1.10]), and history of CIAD (HR 1.43 [95 % CI 1.02-2.00]) were independently associated with mortality during long-term follow-up. However, CIAD was not significantly associated with short-term mortality after stroke.


CONCLUSIONS
Co-existing CIAD showed no significant association with stroke severity at hospital admission and early mortality after ischemic stroke. CIAD was negatively associated with long-term survival after ischemic stroke.
Department of Neurology, Charité, Universitätsmedizin Berlin, Berlin, Germany. georg.haeusler@charite.de.|Center for Stroke Research Berlin, Charité, Berlin, Germany. georg.haeusler@charite.de.
Karl Georg
KG
Haeusler
Department of Neurology, Charité, Universitätsmedizin Berlin, Berlin, Germany. juliane.herm@charite.de.
Juliane
J
Herm
Department of Neurology, Charité, Universitätsmedizin Berlin, Berlin, Germany. maria.konieczny@charite.de.
Maria
M
Konieczny
Center for Stroke Research Berlin, Charité, Berlin, Germany. ulrike.grittner@charite.de.|Department of Biostatistics and Clinical Epidemiology, Charité, Berlin, Germany. ulrike.grittner@charite.de.
Ulrike
U
Grittner
Departments of Cardiology and Research and Education, General Hospital Celje, Celje, Slovenia. mitja.lainscak@guest.arnes.si.
Mitja
M
Lainscak
Department of Neurology, Charité, Universitätsmedizin Berlin, Berlin, Germany. matthias.endres@charite.de.|Center for Stroke Research Berlin, Charité, Berlin, Germany. matthias.endres@charite.de.|Excellence Cluster NeuroCure, Charité, Universitätsmedizin Berlin, Berlin, Germany. matthias.endres@charite.de.|German Center for Neurodegenerative Diseases (DZNE), Partner Site, Berlin, Germany. matthias.endres@charite.de.|German Center for Cardiovascular Diseases (DZHK), Partner Site, Berlin, Germany. matthias.endres@charite.de.
Matthias
M
Endres
Center for Stroke Research Berlin, Charité, Berlin, Germany. wolfram.doehner@charite.de.|German Center for Cardiovascular Diseases (DZHK), Partner Site, Berlin, Germany. wolfram.doehner@charite.de.|Department of Cardiology, Charité Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany. wolfram.doehner@charite.de.
Wolfram
W
Doehner
D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D001281:Atrial Fibrillation / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality*