Does the second ischemic stroke herald a higher proportional risk for cognitive and physical impairment than the first-ever one?

Abstract

Background Post-stroke cognitive and physical disabilities are common sequelae; however, it seems that the second ischemic stroke carries a higher proportional risk more than expected. In this study, we aimed to study second stroke sequelae over first-ever one with regard to cognition and physical competence. This study was conducted on two groups; the first composed of 40 patients with acute first lifetime ischemic stroke, and the second group composed of 40 acute second lifetime ischemic stroke. The study was done at menoufiya university hospitals from August 2017 to August 2018. Modified Rankin Scale (MRS), National Institute of Health Stroke Scale (NIHSS), and MINI-Cog Score, were performed at onset, 2 weeks and 3 months later. In addition, routine lab and neuro-imaging were also done. Results Size of infarction is larger in 2nd group (p < 0.001), MRS, and NIHSS are significantly higher in 2nd group. Also, there are significant differences between baseline, 2 weeks, and 3 months follow-up in MRS and NIHSS. Mini-Cog scale showed significant difference between the two groups in favor of better cognition in the 1st group. Atrial fibrillation (AF), p = 0.012 was a significant risk factor in the 1st group while smoking, p = 0.017 was the significant risk factor in the 2nd group. Large size stroke was found as independent risk factor in the 2nd group (p < 0.001). Conclusions There are significant cognitive and physical disabilities in the second recurrent ischemic stroke as compared to the first-ever one, and the second stroke tend to be more dangerous and carry more disability.

Predictors of functional outcome after stroke: Sex differences in older individuals

“…The independent variables that were analyzed in the model were age, NIHSS, thrombolysis, thrombectomy, previous stroke, diabetes, atrial fibrillation, and prestroke independence. They were selected on the basis of prior literature and research 24–30 . To enhance the robustness of our analysis, we performed simple bootstrapping with 1000 samples and computed a 95% confidence interval (CI) using bias‐corrected and accelerated methods.…”

“…They were selected on the basis of prior literature and research. [24][25][26][27][28][29][30] To enhance the robustness of our analysis, we performed simple bootstrapping with 1000 samples and computed a 95% confidence interval (CI) using bias-corrected and accelerated methods. The multicollinearity assumption was checked with the variance inflation factor (VIF), where a cutoff value of 2.5 was used.…”

The effect of swallowing exercises in combination with Benson relaxation on swallowing ability in stroke patients

“…Patients who have had a stroke have a high risk of a recurrent stroke (Elwan et al, 2021). Repeat strokes ranged from 30-43% within 5 years.…”

“…In recurrent strokes, the disorders experienced will get worse -and increase the risk of disability and death (Oza et al, 2017). Research conducted by Elwan et al (2021) found that lesions which occur in recurrent stroke patients are more extensive than in patients experiencing their first stroke. The study concluded that patients experiencing a second stroke will have significant cognitive and physical disability compared to the first attack.…”