Predictors of poor outcomes in First-Event Ischemic Stroke as assessed by Magnetic Resonance Imaging.

ABSTRACT

PURPOSE: Stroke is the third most common cause of mortality worldwide and is a major cause of permanent disability. The purposed of the study was to better understand the risk factors for poor outcomes following ischemic stroke requiring treatment. METHODS: Three hundred seventy patients with first-event ischemic stroke were enrolled. Good outcomes was defined as a using the Modified Rankin Scale (MRS) score ≤3 without any cardiovascular event, while poor outcomes were any of the following end points MRS >3 at 3 months, recurrent stroke or death. Prognostic variables for poor outcomes were analyzed based on a stepwise logistic regression model. RESULTS: Seventy-eight patients had poor outcomes (21%, 78/370), assessed at a minimum of six-month follow-up. Higher mean National Institutes of Health Stroke Scale (NIHSS) scores at presentation, presence of early neurologic deterioration (END) and higher mean high-sensitivity C-reactive protein (hs-CRP) levels were associated with poor outcomes at discharge. Furthermore, both NIHSS at presentation and the presence of END were associated with poor outcomes, assessed at a minimum of six-month follow-up. CONCLUSION: A higher mean initial NIHSS score implies not only severe neurologic deficits but also an increased risk of poor outcomes. Since END following ischemic stroke is frequently associated with poor outcomes, more attention should be directed to providing adequate treatment to patients in the acute stage, especially for high risk patients.