title: Outcome Predictors in First-Ever Ischemic Stroke Patients: A Population-Based Study.
abstract: Background. There is scant population-based information regarding predictors of stroke severity and long-term mortality for first-ever ischemic strokes. The aims of this study were to determine the characteristics of patients who initially presented with first-ever ischemic stroke and to identify predictors of severity and long-term mortality. Methods. Data were collected from the population-based Cerebrovascular Aosta Registry. Between 2004 and 2008, 1057 patients with first-ever ischemic stroke were included. Variables analysed included comorbidities, sociodemographic factors, prior-to-stroke risk factors, therapy at admission and pathophysiologic and metabolic factors. Multivariate logistic regression models, Kaplan-Meier estimates, and Cox proportional Hazards model were used to assess predictors. Results. Predictors of stroke severity at admission were very old age (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.75-5.06), female gender (OR 1.73, 95% CI 1.21-2.40), atrial fibrillation (OR 2.76, 95% CI 1.72-4.44), low ejection fraction (OR 2.22, CI 95% 1.13-4.32), and cardioembolism (OR 2.0, 95% CI 1.36-2.93). Predictors of long-term mortality were very old age (hazard ratio [HR] 2.02, 95% CI 1.65-2.47), prestroke modified Rankin scale 3-5 (HR 1.82; 95% CI 1.46-2.26), Charlson Index ≥2 (HR 1.97; 95% CI 1.62-2.42), atrial fibrillation (HR 1.43, 95% CI 1.04-1.98), and stroke severity (HR 3.54, 95% CI 2.87-4.36). Conclusions. Very old age and cardiac embolism risk factors are the independent predictors of stroke severity. Moreover, these factors associated with other comorbid medical conditions influence independently long-term mortality after ischemic stroke.
authors.affiliation: Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corso
authors.affiliation: Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy.
authors.forename: Edo
authors.initials: E
authors.lastname: Bottacchi
authors.affiliation: Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Tosi
authors.affiliation: Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Caligiana
authors.affiliation: Department of Neurology, Stroke Unit Ospedale Regionale, Viale Ginevra, No., 11100 Aosta, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lia
authors.affiliation: Statistics Department, Ospedale Regionale, Viale Ginevra 3, 11100 Aosta, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Veronese Morosini
authors.affiliation: Department of Scienze della Sanità Pubblica, Università degli Studi di Torino, Via Verdi 8, 10124 Torino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Dalmasso