IN-HOSPITAL STROKE RECURRENCE OF ACUTE ISCEMIC STROKE

Abstract

BACKROUND: Stroke survivors are athigh risk of recurrent stroke, communitybasedstudies show that this risk is about30%. Recurrent strokes tend to be moredeadly than the first stroke and lead tofurther neurological impairment. In thissudy, in-hospital stroke recurrence ina university hospital stroke unit settingwere investigated.PATIENTS AND METHODS: Strokeregistry data of 2128 patients hospitalizedat the Istanbul Faculty of Medicine,Department of Neurology, Edip AktinStroke Unit between 1994-2007 wereevaluated. Recurent stroke was definedas a new neurological deficit not causedby neurological complications such asedema, mass effect or hemorrhagic transformationor progression of the indexevent. Clinical, laboratory and neuroimagingfindings of 67 recurrent ischemicstroke patients were compared with ischemicstroke patients (n = 1658) withoutany recurrence. Statistical methods usedwere; chi-squared test for parametricvariables, t-test for continuous variablesand univariate and multivariate analysisusing SPSS version 15.0.RESULTS: In- hospital stroke reccurencerate was 3.9% (n = 83/2128) inall stroke patients and %4 in ischemicstroke (IS) patients. There were no statisticallysignificant differences betweenIS patients with and without recurrencein terms of demographic features, andmost traditional risk factors. Only peripheralvascular disease frequency wassignificantly higher in the recurrent stroke group (p = 0.05, 95% CI = 0.98 to5.524). Posterior circulation syndrome(POCS) and was significantly more frequentlyencountered in the recurrentstroke group (p = 0.012).The most importantfactor in determining the recurrenceof IS was large artery atherosclerosis(LAS) (p <0.001, 95% CI = 0.062 to0.44).CONCLUSION: In a stroke unit whereacute stroke treatments were mostly unavailable,a higher in-hospital stroke recurrencerate associated with LAS in ISpatients may be indicative of the importanceof early theraputic intervention.