In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 44, No. suppl_1 ( 2013-02)
Abstract:
Background: Cardioembolic (CE) strokes are more disabling and more fatal than non-CE strokes. Multiple prognostic factors have been recognized, but the magnitude of their relative contribution has not been well explored. Methods: Using a stroke outcome registry, we compared the outcomes of CE and non-CE strokes. The relative contribution of prognostic factors was assessed with multivariable models and model fitness improvement using -2 log-likelihood and Nagelkerke’s R 2 . Results: A total of 1233 patients were included in this analysis. As compared to non-CE strokes, CE strokes had less mRS 0-2 outcomes (47.2% vs 68.5%, p 〈 0.001), less mRS 0-1 outcomes (33.7% vs 53.5%, p 〈 0.001), more mRS 5-6 outcomes (32.1% vs 10.9%, p 〈 0.001), and higher mortality (19.2% vs 5.2%, p 〈 0.001). When adjusting either baseline demographics or poststroke complications, the outcome differences remained significant. However, adjusting initial NIHSS score alone abolished the differences in mRS 0-2 outcome (Figure) and mRS 0-1 and mRS 5-6 outcomes. For mRS 0-2 outcome, the differences in -2 log-likelihood and Nagelkerke’s R 2 between univariable model and multivariable model were greater with adjusting NIHSS alone (-2 log-likelihood difference, 418; Nagelkerke’s R 2 difference, 38.7%) than with adjusting baseline demographics (184; 17.7%) or poststroke complication (279; 27.3%). Further adjustment of baseline demographics and poststroke complication to the initial NIHSS score adjustment resulted in a small shift of odds ratio. The decrement of -2 log-likelihood and the Nagelkerke’s R 2 of the model adjusting initial NIHSS score alone approached 70.2% and 76.7% of the model adjusting baseline demographics, poststroke complication, and initial NIHSS score. Conclusion: Greater stroke severity predominates over all other factors for the worse outcome of CE stroke.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/str.44.suppl_1.AWP400
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2013
detail.hit.zdb_id:
1467823-8
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