The impact of smoking on the severity of acute ischemic stroke

Smoking Status and Severity of Ischemic Stroke. A Population-Based Study

“…Moreover, only a few studies have taken into consideration the IS mechanism in multivariable analyses [4,5,7,10,11], even though it is strongly associated with initial severity, and the prevalence of smoking varies considerably according to the mechanism. Of note, our findings indicating that lower severity was observed in patients with either lacunar IS or IS from other etiology (including patients with cervical artery dissection), and that higher severity was noted in those with cardioembolic IS are in accordance with the literature [6,9,11,19]. Our results were also adjusted for several vascular risk factors, which may also have an impact on severity and for which distribution also differs according to smoking status.…”

“…Both were limited by relatively small samples of 377 and 246 patients, respectively, and no distinction was made between current and former smokers. Similarly, hospital-based studies also provided divergent findings for the association between smoking status and stroke severity [4,5,6,7,10,11], which could probably be explained by differences in the characteristics of the patients recruited and in the confounding variables considered in the multivariable analyses. Especially in most of these studies [4,5,10,11], no adjustment was made for age at onset although our study, as well as others [4,6], showed that smokers develop IS at a younger age than non-smokers.…”

“…Similarly, hospital-based studies also provided divergent findings for the association between smoking status and stroke severity [4,5,6,7,10,11], which could probably be explained by differences in the characteristics of the patients recruited and in the confounding variables considered in the multivariable analyses. Especially in most of these studies [4,5,10,11], no adjustment was made for age at onset although our study, as well as others [4,6], showed that smokers develop IS at a younger age than non-smokers. Moreover, only a few studies have taken into consideration the IS mechanism in multivariable analyses [4,5,7,10,11], even though it is strongly associated with initial severity, and the prevalence of smoking varies considerably according to the mechanism.…”

“…These results could be explained by a less severe baseline stroke severity in smoking patients [6,7,8], but other studies failed to demonstrate such an association [4,5,9,10,11]. These conflicting data may be partly explained by several limitations in previous studies including either a small sample size [4,5,8,9,11], a hospital-based setting [4,5,6,7,10,11], or a lack of control for potential confounding factors in multivariable analyses, especially the etiological mechanisms of IS [4,5,7,8,10,11]. …”

Depression after minor stroke: Prevalence and predictors

“…Current smokers had higher NIHSS scores on admission [23] and poorer functional outcome at discharge [24] compared with nonsmokers or former smokers. Both higher NIHSS score and disability are considered major predictors of PSD, which might mediate the association between smoking and PSD.…”