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- Publisher Website: 10.1093/qjmed/hcl082
- Scopus: eid_2-s2.0-33749584360
- PMID: 16905751
- WOS: WOS:000240428000006
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Article: Early neurological deterioration in acute stroke: Clinical characteristics and impact on outcome
Title | Early neurological deterioration in acute stroke: Clinical characteristics and impact on outcome |
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Authors | |
Issue Date | 2006 |
Citation | QJM, 2006, v. 99 n. 9, p. 625-633 How to Cite? |
Abstract | Background: A significant proportion of acute stroke patients suffer neurological deterioration during the first few days of recovery. Aim: To explore the frequency, clinical characteristics, and consequences of early neurological deterioration during the acute recovery period. Methods: We assessed all consecutive patients admitted to a University hospital with suspected stroke. We recorded the following on admission: baseline characteristics, physiological parameters and laboratory results. On day 5 we recorded occurrence of complications, and functional outcome. Early neurological deterioration was defined as an increase in National Institute of Health Stroke Score (NIHSS) by two or more points (or stroke-related death) between admission and day 5. Results: We recruited 188 stroke patients, of whom 36 (19%) suffered early neurological deterioration. Patients with early neurological deterioration were significantly more likely to: (i) arrive at the hospital earlier (median 2.25 vs. 7.2 h, p = 0.015); (ii) have a history of atrial fibrillation (33% vs. 16%, p = 0.039); (iii) be current non-smokers (24% vs. 11%, p = 0.041); (iv) have a severe stroke - more total anterior circulation strokes (67% vs. 26%, p < 0.001) and worse NIHSS and GCS scores; (v) have intracerebral haemorrhage (22% vs. 7%, p = 0.011); (vi) have higher serum urea (mean 7.8 vs. 6.5 mmol/l, p = 0.035) and leukocyte count (mean 12.6 vs. 9.7 × 10 9/l, p = 0.044); and (vi) die in hospital (44% vs. 10%, OR 12.8, 95%CI 3.8-43.1, p < 0.001). Discussion: Early neurological deterioration is a frequent and important complication in acute stroke, with a poor short-term prognosis. Effective treatment strategies are urgently needed to reduce its occurrence and impact on recovery. © 2006 Oxford University Press. |
Persistent Identifier | http://hdl.handle.net/10722/194168 |
ISSN | 2022 Impact Factor: 13.3 2020 SCImago Journal Rankings: 0.427 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Kwan, J | - |
dc.contributor.author | Hand, P | - |
dc.date.accessioned | 2014-01-30T03:32:15Z | - |
dc.date.available | 2014-01-30T03:32:15Z | - |
dc.date.issued | 2006 | - |
dc.identifier.citation | QJM, 2006, v. 99 n. 9, p. 625-633 | - |
dc.identifier.issn | 1460-2725 | - |
dc.identifier.uri | http://hdl.handle.net/10722/194168 | - |
dc.description.abstract | Background: A significant proportion of acute stroke patients suffer neurological deterioration during the first few days of recovery. Aim: To explore the frequency, clinical characteristics, and consequences of early neurological deterioration during the acute recovery period. Methods: We assessed all consecutive patients admitted to a University hospital with suspected stroke. We recorded the following on admission: baseline characteristics, physiological parameters and laboratory results. On day 5 we recorded occurrence of complications, and functional outcome. Early neurological deterioration was defined as an increase in National Institute of Health Stroke Score (NIHSS) by two or more points (or stroke-related death) between admission and day 5. Results: We recruited 188 stroke patients, of whom 36 (19%) suffered early neurological deterioration. Patients with early neurological deterioration were significantly more likely to: (i) arrive at the hospital earlier (median 2.25 vs. 7.2 h, p = 0.015); (ii) have a history of atrial fibrillation (33% vs. 16%, p = 0.039); (iii) be current non-smokers (24% vs. 11%, p = 0.041); (iv) have a severe stroke - more total anterior circulation strokes (67% vs. 26%, p < 0.001) and worse NIHSS and GCS scores; (v) have intracerebral haemorrhage (22% vs. 7%, p = 0.011); (vi) have higher serum urea (mean 7.8 vs. 6.5 mmol/l, p = 0.035) and leukocyte count (mean 12.6 vs. 9.7 × 10 9/l, p = 0.044); and (vi) die in hospital (44% vs. 10%, OR 12.8, 95%CI 3.8-43.1, p < 0.001). Discussion: Early neurological deterioration is a frequent and important complication in acute stroke, with a poor short-term prognosis. Effective treatment strategies are urgently needed to reduce its occurrence and impact on recovery. © 2006 Oxford University Press. | - |
dc.language | eng | - |
dc.relation.ispartof | QJM | - |
dc.title | Early neurological deterioration in acute stroke: Clinical characteristics and impact on outcome | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1093/qjmed/hcl082 | - |
dc.identifier.pmid | 16905751 | - |
dc.identifier.scopus | eid_2-s2.0-33749584360 | - |
dc.identifier.volume | 99 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 625 | - |
dc.identifier.epage | 633 | - |
dc.identifier.isi | WOS:000240428000006 | - |
dc.identifier.issnl | 1460-2393 | - |