Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project)

Sandercock, Peter; Bamford, John; Dennis, Martin; Burn, John; Slattery, Jim; Jones, Lesley; Boonyakarnkul, Surat; Warlow, Charles

doi:10.1136/bmj.305.6867.1460

Cited by 228 publications

(167 citation statements)

References 43 publications

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“…Pre-existing congestive heart failure [32][33][34] and atrial arrhythmia 32,33,[35][36][37] are well-documented risk factors for mortality after stroke, and our findings suggest a prognostic significance of these conditions in thrombolysis patients. However, in our study, the increased risk of mortality attributable to these conditions is very similar in thrombolysis and nonthrombolysis patients, suggesting that these conditions should probably not be considered contraindications to thrombolysis.…”

Section: Bateman Et Al Thrombolysis Nationwide Inpatient Samplementioning

confidence: 69%

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Bateman

Schumacher

Boden‐Albala

et al. 2006

Stroke

111

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Background and Purpose-The prospective trials evaluating the safety and efficacy of intravenous tissue plasminogen activator have generally been conducted at academic medical centers and community hospitals with an institutional commitment to stroke care. Relatively little is known about the safety of this therapy as it is used in the community. We therefore examined outcomes in acute stroke patients treated with thrombolysis using the largest discharge database available in the United States for the years 1999 to 2002. Methods-Data were derived from the Nationwide Inpatient Sample for the years 1999 to 2002. Using the appropriateInternational Classification of Disease-Clinical Modification, 9th revision, codes, patients admitted through the emergency room with a primary diagnosis of acute ischemic stroke were selected for analysis. From these patients, those coded as receiving thrombolysis were identified. Multivariate logistic regression was performed on the thrombolysis and nonthrombolysis cohorts to identify independent predictors of in-hospital mortality from among those clinical elements available in the database. Results-We identified 2594 patients treated with thrombolysis from a group of 248 964 patients admitted through the emergency room with a primary diagnosis of acute ischemic stroke. The thrombolysis cohort had a higher in-hospital mortality rate compared with the nonthrombolysis patients (11.4% versus 6.8%). The rate of intracerebral hemorrhage was 4.4% for the thrombolysis cohort and 0.4% for nonthrombolysis patients. Multivariate logistic regression showed advanced age, Asian/Pacific Islander race, congestive heart failure, and atrial fibrillation/flutter to be independent predictors of in-hospital mortality after thrombolysis. Thrombolysis volume, overall ischemic stroke volume, and teaching status were not significant predictors of in-hospital mortality after thrombolysis. Conclusions-Thrombolysis, as it is used in the community, has a safety profile that is similar to that observed in the large, prospective clinical trials. (Stroke. 2006;37:440-446.)

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Section: Bateman Et Al Thrombolysis Nationwide Inpatient Samplementioning

confidence: 69%

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Bateman

Schumacher

Boden‐Albala

et al. 2006

Stroke

111

View full text Add to dashboard Cite

show abstract

“…[2][3][4] AF is present in 15-21% of patients affected by stroke. [5][6][7][8][9][10][11] In a clinical study in Hokkaido, a northern part of Japan, the incidence of ischaemic events in 20 000 patients with AF, who were followed up in cardiovascular clinics, was 4.6% during a 1.7 year follow up period. 12 Patients with AF have an increased risk of major, disabling stroke, often caused by large infarctions in the middle cerebral artery territory.…”

mentioning

confidence: 99%

Atrial fibrillation as a predictive factor for severe stroke and early death in 15 831 patients with acute ischaemic stroke

Kimura

2005

Journal of Neurology, Neurosurgery & Psychiatry

272

158

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“…Consistent with previous research, age, history of stroke, SBP mean in the acute stage, baseline NIHSS score, stroke subtype, diabetes mellitus, and atrial fibrillation were associated with the 3-month functional outcome. [21][22][23][24][25] In the predefined subacute stage, the median number of BP measurements was 34 (IQR, 20-60). The median time from symptom onset to discharge or transfer was 8.7 days (IQR, 6.8-11.9 days).…”

mentioning

confidence: 99%

Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke

Kang

Park

et al. 2012

Neurology

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Objective: We aimed to study various measures of blood pressure (BP) in the subacute phase of ischemic stroke to determine whether any of them predicted clinical outcome. Methods:In this retrospective observational study, a consecutive series of patients hospitalized for ischemic stroke within 48 hours of onset were enrolled. The subacute stage of stroke was defined as the time period from 72 hours of symptom onset to discharge or transfer. During this period, mean, maximum, maximum 2 minimum, SD, and coefficient of variation of systolic BP (SBP) and diastolic BP (DBP) were determined. A baseline severity-adjusted analysis was performed using each patient's 3-month modified Rankin Scale score as the primary outcome.Results: Among a total of 2,271 patients, the median number of BP measurements was 34 per person and the median interval from onset to discharge was 8.7 days. Measures of variability of BP were associated with poor outcome. One SD increase of maximum 2 minimum (odds ratio [OR] Conclusion: This study shows that variability of BP, but not average BP in the subacute stage of ischemic stroke, is associated with functional outcome at 3 months after stroke onset. Neurology

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Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project)

Cited by 228 publications

References 43 publications

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Factors Associated With In-Hospital Mortality After Administration of Thrombolysis in Acute Ischemic Stroke Patients

Atrial fibrillation as a predictive factor for severe stroke and early death in 15 831 patients with acute ischaemic stroke

Effect of blood pressure on 3-month functional outcome in the subacute stage of ischemic stroke

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