Predictors Of Early Mortality And Bad Outcome In Ischemic Stroke (P3.072)

Background and purpose: stroke is a major public health problem and identification of predictors of mortality and bad outcome crucial in decision making regarding care provision. We assessed clinical variables related to 30-day mortality and bad outcome in a quality-of-care stroke secondary prevention program. Methods: consecutive acute ischemic stroke patients were included in the analysis. Demographic data, vascular risk factors profile and disability (modified Rankin scale) were evaluated one month after the event, and were analyzed in two groups of patients: 1) bad oucome (death or m-Rankin > 1), and 2) good outcome (those with none of these characteristics). Results: we analyzed data of the 1194 ischemic stroke patients included between December 2006 and December 2013. Pre-stroke vascular risk factor profile was: hypertension 82[percnt], dislipidemia 65[percnt], obesity 48[percnt], metabolic syndrome 42[percnt], smoking 38[percnt], atrial fibrillation 17[percnt], diabetes 14[percnt], history of stroke 16[percnt], coronary heart disease 17[percnt], peripheral vascular disease 11[percnt]. In the univariate analysis bad outcome was associated with age, female sex, NIHSS > 10 points at admission , atrial fibrillation, previous stroke, obesity , renal failure, and elevated pulse pressure at admission and hospitalization > 1week .Predictors of bad outcome in multivariate analysis were: female sex (OR 1.93, 95[percnt]CI 1.39-2.67; p 0.0001), age > 80 years (OR 1.80, 95[percnt]CI 1.80-3.42; p 0.0001), NIHSS > 10 (OR 7.01, 95[percnt]CI 3.59-13.6; p 0.0001), hospitalization > 1 week (OR 4.53, 95[percnt]CI 3.21-7.58; p 0.0001), history of stroke (OR 1.86, 95[percnt]CI 1.19-2.88; p 0.006), atrial fibrillation (OR 1.66, 95[percnt]CI 1.60-2.49; p 0.01). Conclusion: identifying predictors of early mortality or post-stroke disability is mandatory in order to recognize opportunities of improvement and develop strategies for clinical care in this specific subgroup of patients. A multidisciplinary approach is essential to reduce clinical complications and to improve follow up after the hospitalization period. Disclosure: Dr. Luzzi has nothing to disclose. Dr. Zurru has nothing to disclose. Dr. Alonzo has nothing to disclose. Dr. Brescacin has nothing to disclose. Dr. Pigretti has nothing to disclose. Dr. Camera has nothing to disclose. Dr. Colla Machado has nothing to disclose. Dr. Waisman has nothing to disclose. Dr. Cristiano has received personal compensation for activities with Bayer, Biogen Idec, Merck & Co., Inc., and Novartis.