Pre-stroke factors (morbitities, diet, medication, demograhics) that affect the severity of a stroke

Poupore, Nicolas; Okon, Marvin; Mackey, Tristan; Nathaniel, Thomas I.

doi:10.1016/j.tru.2021.100073

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…In previous studies, lower BP levels were associated with improved prognosis in patients treated with AIS, while higher BP levels were associated with poor treatment outcomes [ 28 , 29 ]. Our results extend beyond previous reports on elevated BP and stroke severity in the non-telestroke setting [ 22 , 23 , 30 , 31 ]. Most studies did not report specific risk factors associated with stroke severity in AIS patients with elevated DBP.…”

Section: Discussionsupporting

confidence: 88%

“…Several risk factors, such as diabetes, hypertension, atrial fibrillation, coronary and peripheral artery disease, heart failure, and age, have been associated with stroke severity [ 22 , 23 , 24 ]. In addition, the severity conferred by the different risk factors often clusters among those with pre-existing hypertension and may significantly contribute to stroke severity [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Stroke Severity in Ischemic Stroke Patients with a History of Diastolic Blood Pressure Treated in a Telestroke Network

Brown

Terrell

Goodwin

et al. 2022

JCDD

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Background: The relationship between diastolic blood pressure (DBP), risk factors, and stroke severity in acute ischemic stroke (AIS) patients treated in a telestroke network is not fully understood. The present study aims to determine the effect of risk factors on stroke severity in AIS patients with a history of elevated DBP. Material and Methods: We retrospectively analyzed data on stroke severity for AIS patients treated between January 2014 and June 2016 treated in the PRISMA Health telestroke network. Data on the severity of stroke on admission were evaluated using NIHSS scores ≤7 for reduced, and >7 for increased, stroke severity. DBP was stratified as ≤80 mmHg for reduced DBP and >80 mmHg for elevated DBP. The study’s primary outcomes were risk factors associated with improving neurologic functions or reduced stroke severity and deteriorating neurologic functions or increased stroke severity. The associations between risk factors and stroke severity for AIS with elevated DBP were determined using multi-level logistic and regression models. Results: In the adjusted analysis, AIS patients with a DBP ≤ 80 mmHg, obesity (OR = 0.388, 95% Cl, 0.182–0.828, p = 0.014) was associated with reduced stroke severity, while an increased heart rate (OR = 1.025, 95% Cl, 1.001–1.050, p = 0.042) was associated with higher stroke severity. For AIS patients with a DBP > 80 mmHg, hypertension (OR = 3.453, 95% Cl, 1.137–10.491, p = 0.029), history of smoking (OR = 2.55, 95% Cl, 1.06–6.132, p = 0.037), and heart rate (OR = 1.036, 95% Cl, 1.009–1.064, p = 0.009) were associated with higher stroke severity. Caucasians (OR = 0.294, 95% Cl, 0.090–0.964, p = 0.002) and obesity (OR = 0.455, 95% Cl, 0.207–1.002, p = 0.05) were more likely to be associated with reduced stroke severity. Conclusions: Our findings reveal specific risk factors that can be managed to improve the care of AIS patients with elevated DBP treated in the telestroke network.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Stroke Severity in Ischemic Stroke Patients with a History of Diastolic Blood Pressure Treated in a Telestroke Network

Brown

Terrell

Goodwin

et al. 2022

JCDD

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“…Patients with an NIHSS score ≤7 at the time of admission are reported to be more likely to make positive neurologic progress, whereas AIS patients presenting with an NIHSS score >7 are more likely to experience worsening neurologic outcomes after a hemispheric stroke [8]. Moreover, findings from existing studies [10, 24, 25] reveal that there is a strong predictive value of early NIHSS scores, which will improve early identification of neurologic functional deficits in hemispheric stroke patients, both in non-telestroke and telestroke settings.…”

Section: Methodsmentioning

confidence: 99%

“…Another study found that men are three times more likely to present with improved functional outcomes with rtPA treatment than women [ 4 ]. In general, the observed gender differences have been attributed to several factors such as age [ 5 , 6 ], comorbidity [ 7 , 8 ], prestroke functional status [ 9 , 10 ], and stroke severity [ 7 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Stroke Severity among Men and Women Acute Ischemic Stroke Patients in the Telestroke Network

Poupore

Edrissi

Sowah

et al. 2022

Cerebrovasc Dis Extra

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Introduction. This study investigates gender differences among stroke patients treated in the telestroke network using specific risk factors that contribute to stroke severity. Methods. We examined gender differences in stroke severity among 454 patients hospitalized with acute ischemic stroke (AIS). The logistic regression model was used to predict clinical risk factors associated with stroke severity in men and women AIS patients. Results. In the adjusted analysis, among women patients, increasing age [Odd ratio(OR) = 1.05, 95% CI, 1.017-1.085, P = 0.003], and higher heart rate (OR = 1.031, 95% CI, 1.005-1.058, P=0.021) were associated with worsening neurological functions, while direct admission (OR = 0.191, 95% CI, 0.079‐0.465, P<0.001) was associated with improving neurologic functions. Among men, hypertension (OR = 3.077, 95% CI, 1.060‐8.931, P = 0.039), and higher international normalized ratio (INR) (OR=21.959, 95% CI, 1.489-323.912, P=0.024) were associated with worsening neurologic functions, while Caucasian (OR=0.181, 95% CI, 0.062-0.526, P=0.002) and obesity (OR=0.449, 95% CI, 0.203-0.99, P=0.047) were associated with neurologic improvement. Conclusion. Increasing age and heart rate in women, hypertension and greater INR in men contribute to worsening neurologic functions. There is the need to develop strategies to improve the care of both men and women in the telestroke network.

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“…These studies were not performed in a telestroke network, and generally did not evaluate the effect of risk factors and their interaction with levels of DBP. Pre-stroke factors, such as morbidities, diet, medication and demographics, may also affect the severity of a stroke [ 8 ]. Brown et al performed a retrospective analysis of 452 AIS patients in a telestroke network, mean age 64 years, 51.3% female [ 9 ].…”

mentioning

confidence: 99%

Advances in Neurological Diseases and Stroke

Venketasubramanian

2023

JCDD

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Pre-stroke factors (morbitities, diet, medication, demograhics) that affect the severity of a stroke

Cited by 7 publications

References 27 publications

Stroke Severity in Ischemic Stroke Patients with a History of Diastolic Blood Pressure Treated in a Telestroke Network

Stroke Severity in Ischemic Stroke Patients with a History of Diastolic Blood Pressure Treated in a Telestroke Network

Stroke Severity among Men and Women Acute Ischemic Stroke Patients in the Telestroke Network

Advances in Neurological Diseases and Stroke

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