OUTCOME, PREDICTOR AND FUNCTIONAL RECOVERY OF ISCHEMIC STROKE SUBTYPES (TOAST): THE SOUTH LONDON STROKE REGISTER

TY - JOUR

T1 - OUTCOME, PREDICTOR AND FUNCTIONAL RECOVERY OF ISCHEMIC STROKE SUBTYPES (TOAST): THE SOUTH LONDON STROKE REGISTER

AU - Wafa, Hatem Abdelaziz Mohamed

AU - Rudd, Anthony

AU - Wolfe, Charles David Alexander

AU - Wang, Yanzhong

PY - 2017/5

Y1 - 2017/5

N2 - Background and Aims: We aim to estimate short and long-term outcomes and their predictors in ischemic stroke subtypes.Method: First-ever ischemic strokes registered between 1999 and 2015 in the South London Stroke Register (n¼2541) were categorised according to modified TOAST criteria into: large artery atherosclerosis (LAA), cardio-embolism (CE), small vessel occlusion (SVO), other determined aetiologies (OTH), undetermined aetiologies (UND), and concurrent aetiologies (CONC). Baseline data included sociodemographics, case mix, prior risk factors, acute stroke processes, with outcomes up to 10 years after stroke. Multiple logistic regression was used to estimate differences in poor outcome (dead or dependent: Barthel Index <15) and associated predictors among groups; multiple linear regression was implemented to determine functional recovery on Barthel score.Results: Age and functional status at 7 days after stroke were the best predictors of short and long-term poor outcomes for all groups. Compared with SVO, LAA had poorer outcome at 7 days (odds ratio (OR): 1.97 (95% CI: 1.33–2.94)) and 2 years (OR: 1.94 (1.25–3)). CE had significantly poorer outcome than SVO over time (OR: 1.4 to 2.6). However, the improvement of functional outcome in the first 3 months after stroke was significantly greater among CE survivors than SVO patients (adjusted regression coefficient: 0.87 (0.07–1.67)).Conclusion: Functional outcome after stroke improves over time in all subtypes. Patients with SVO have the best outcomes. CE survivors have the greatest recovery in the first 3 months despite their poorer prognosis. Identifying predictors and trajectories of recovery are important to management of stroke recovery.

AB - Background and Aims: We aim to estimate short and long-term outcomes and their predictors in ischemic stroke subtypes.Method: First-ever ischemic strokes registered between 1999 and 2015 in the South London Stroke Register (n¼2541) were categorised according to modified TOAST criteria into: large artery atherosclerosis (LAA), cardio-embolism (CE), small vessel occlusion (SVO), other determined aetiologies (OTH), undetermined aetiologies (UND), and concurrent aetiologies (CONC). Baseline data included sociodemographics, case mix, prior risk factors, acute stroke processes, with outcomes up to 10 years after stroke. Multiple logistic regression was used to estimate differences in poor outcome (dead or dependent: Barthel Index <15) and associated predictors among groups; multiple linear regression was implemented to determine functional recovery on Barthel score.Results: Age and functional status at 7 days after stroke were the best predictors of short and long-term poor outcomes for all groups. Compared with SVO, LAA had poorer outcome at 7 days (odds ratio (OR): 1.97 (95% CI: 1.33–2.94)) and 2 years (OR: 1.94 (1.25–3)). CE had significantly poorer outcome than SVO over time (OR: 1.4 to 2.6). However, the improvement of functional outcome in the first 3 months after stroke was significantly greater among CE survivors than SVO patients (adjusted regression coefficient: 0.87 (0.07–1.67)).Conclusion: Functional outcome after stroke improves over time in all subtypes. Patients with SVO have the best outcomes. CE survivors have the greatest recovery in the first 3 months despite their poorer prognosis. Identifying predictors and trajectories of recovery are important to management of stroke recovery.

U2 - 10.1177/2396987317705242

DO - 10.1177/2396987317705242

M3 - Meeting abstract

SN - 2396-9873

VL - 2

SP - 194

EP - 194

JO - European Stroke Journal

JF - European Stroke Journal

IS - 1_suppl

M1 - AS13-016

T2 - European Stroke Organisation Conference 2017, Prague, May 2017

Y2 - 15 May 2017 through 18 May 2017

ER -