22. European Stroke Conference 57 Stroke prognosis Post-stroke seizures impair long term functional outcome after a young stroke. The FU-TURE- 308 © 2013 S. Karger AG, Basel Scientific Programme study. R.M. Arntz1, N.A. Maaijwee2, L.C. Rutten-Jacobs3, H.C. Schoonderwaldt4, L.D. Dorresteijn5, E.J. van Dijk6, F.E. de Leeuw7 Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour., Nijmegen, THE NETHERLANDS1, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour., Nijmegen, THE NETHERLANDS2, Rad-boud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour., Nijmegen, THE NETHERLANDS3, Radboud University Nijmegen Medical Centre, Donders In-stitute for Brain, Cognition and Behaviour., Nijmegen, THE NETHERLANDS4, Medisch Spec-trum Twente, Enschede, THE NETHERLANDS5, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour., Nijmegen, THE NETHERLANDS6, Rad-boud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour., Nijmegen, THE NETHERLANDS7 Background: Stroke in young adults is a devastating disease with a for unknown reasons poor long term prognosis. Post-stroke seizures are a very common post-stroke complication in the young and may be one of the factors that influence prognosis. However surprisingly little is known about their influence on functional outcome and quality of life in young stroke survivors. Methods: We per-formed a prospective cohort study among 537 stroke survivors with a first-ever TIA, ischemic stroke or intracerebral hemorrhage, aged 18-50 years. Post-stroke seizures were assessed by standardized, structured questionnaires and verified by a neurologist. Relative risks for unfavorable outcome on modified Rankin Score (mRS>2), Barthel Index (BI≤80) and Instrumental Activities of Daily Liv-ing (IADL<8) were calculated by multivariate logistic regression analysis. Results: After mean follow-up of 9.8 years (SD 8.4) 10.1% of the stroke survivors had at least 1 seizure and 4.7% devel-oped recurrent seizures. Across all subtypes, patients with seizures had a worse functional outcome than those without (mRS>2: 20.4% vs 9.1% p=0.010, BI≤80: 12.8% vs 4.1% p=0.010, IADL<8: 23.4% vs 12.4% p=0.036). Patients with recurrent seizures performed worse on ADL-tasks than those without (BI≤80: 17.4% vs 4.4% p=0.005). There were no differences in functional outcome between patients with and without seizures in intracerebral hemorrhage and TIA-patients. Ischemic stroke patients with seizures more often had a poor global functional outcome (mRS>2: OR 2.87, 95% CI 1.09-7.60) and a poor outcome on ADL tasks (BI≤80: OR 3.69, 95% CI 1.05-12.31) than those without, adjusted for confounders. Post-stroke seizures did not affect quality of life measured by the EQ5D. Conclusion: Post-stroke seizures after an ischemic young stroke are not only a com-mon problem but have a negative impact on functional outcome as well, even after more than 10 years of follow-up. 58 Stroke prognosis Validation of the predicitive capacity of the iScore scale at three months in patients treated with rt-PA C. van Eendenburg1, Y. Silva Blas2, M. Terceño Izaga3, J. Serena Leal4, M. Castellanos Rodrigo5 Hospital Universitari Dr. Josep Trueta, Girona, SPAIN1, Hospital Universitari Dr. Josep Trueta, Girona, SPAIN2, Hospital Universitari Dr. Josep Trueta, Girona, SPAIN3, Hospital Universitari Dr. Josep Trueta, Girona, SPAIN4, Hospital Universitari Dr. Josep Trueta, Girona, SPAIN5 Objetives: The iScore scale is a novel tool that permits the estimation of the risk of death or disabil-ity evaluated at one month of evolution in patients with ischaemic stroke. Our aim was to evaluate the predicitive capacity of this scale for the appearance of symptomatic haemorrhagic transforma-tion (STH) and the functional prognosis at 3 months of patients treated with rt-PA at our hospital. Material and methods: The iScore scale was retrospectively quantified and stratified in accordance with previously published data (≤139, 140-179 and ≥180) in 283 patients treated with rt-PA. The functional prognosis was evaluated at 3 months and a modified Rankin scale (mRS) ≤2 was consid-ered as a good prognosis. STH was defined as worsening of ≥4 points on the NIHSS scale associated to bleeding in the cranial-CT at 24-36h post-rtPA. Results: 84 patients had an iScore of ≤139, 109 patients between 149 and 179, and 90 patients ≥180. The percentage of patients with a poor func-tional prognosis at 3 months was significantly greater in patients with an iScore of >180 (p<0.001). 18 patients had STH, which was more frequent in patients with an iScore of ≥ 180 (67 % vs. 33%, p=0.021). In the logistic regression analysis, the iScore ≥ 180 was significantly associated with STH (OR 4.62; 95% CI, 1.35 – 15.78; p=0.0146) and poor functional prognosis (OR 3.02; 95% CI, 1.74 – 5.21; p=0.0001). Conclusions: We have confirmed that iScore is a useful tool in our population to predict the appearance of STH and functional evolution at 3 months in patients treated with rt-PA.
Karger_ESC London_2013
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