22. European Stroke Conference 94 Stroke prognosis Incidence and Prognosis of Eye Movement Abnormalities in Acute Ischemic Stroke R. Puangkasem1, J. Sujjanunt2, C. Danchaivichitr3, C. Komoltri4, y. Nilanont5 Facalty of medicine Siriraj hospital, Mahidol university, Bangkok, THAILAND1, Faculty of medicineSiriraj hospital, Mahidol university, Bangkok, THAILAND2, Faculty of medicineSiriraj hospital, Mahidol university, Bangkok, THAILAND3, 2Siriraj Center of Excellent in Biomedical Research, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, Bangkok, THAILAND4, Faculty of medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, Bang-kok, 330 © 2013 S. Karger AG, Basel Scientific Programme THAILAND5 Background: Eye movement abnormalities (EMAs) are found to be one of the stroke presenting symptoms resulting in disability among survivors. This study aimed to assess incidence, prognosis and predictors of recovery of EMAs. Material and Methods: We performed a single center prospective cohort study. Consecutive patients admitted with acute ischemic stroke were enrolled between June 2011 and December 2012. EMAs were assessed by physical examination, photographs, VDO records. Incidence and prognosis were assessed. Results: A total of 148 patients were enrolled. EMAs were detected in 46 patients (31.5%). The most common forms were conjugate gaze palsy (49%), followed by nystagmus (18.2%), and disconju-gate gaze palsy (14.5%), remaining were impaired fixation, saccades and pursuit. On multivariate analysis, NIHSS >15( p 0.035), Infratentorial lesion (p 0.009) and visual field defect (p 0.026) were independently associated with EMAs. Full recovery of EMAs was found in 28.3% and 78.9% at 1 week and 1 year respectively. Predictors of early recovery were cardioembolic stroke (p 0.035) and supratentorial lesion (p 0.035). Conclusion: EMAs are commonly found in patients with acute ischemic stroke which carry on a good prognosis. The results of our study can be used for counseling support for patients, carers and relatives. 95 Stroke prognosis The ASTRAL score predicts 5-year dependence and mortality in acute ischemic stroke V. Papavasileiou1, H. Milionis2, P. Michel3, K. Makaritsis4, A. Vemmou5, E. Koroboki6, E. Ma-nios7, K. Vemmos8, G. Ntaios9 Department of Medicine, Larissa Medical School, University of Thessaly, Greece, Larisa, GREECE1, Department of Internal Medicine, School of Medicine, University of Ioannina, Greece, Ioannina, GREECE2, Stroke Unit, Neurology Service, Department of Neurosciences, Centre Hos-pitalier Universitaire Vaudois, Switzerland, Lausanne, SWITZERLAND3, Department of Medicine, Larissa Medical School, University of Thessaly, Greece, Larissa, GREECE4, Acute Stroke Unit, Department of Clinical Therapeutics, Alexandra Hospital, Greece, Athens, GREECE5, Acute Stroke Unit, Department of Clinical Therapeutics, Alexandra Hospital, Greece, Athens, GREECE6, Acute Stroke Unit, Department of Clinical Therapeutics, Alexandra Hospital, Greece, Athens, GREECE7, Hellenic Cardiovascular Research Society, Athens, GREECE8, Department of Medicine, Larissa Medical School, University of Thessaly, Greece, Larissa, GREECE9 Background: The ASTRAL score was externally validated showing remarkable consistency on 3-month outcome prognosis in patients with acute ischemic stroke. The present study aimed to eval-uate ASTRAL score’s prognostic accuracy to predict 5-year outcome. Methods: All consecutive patients with acute ischemic stroke registered in the Athens Stroke Regis-try between 01/01/1998 and 31/12/2010 were included. Patients were excluded if admitted >24hours after symptom onset or if any ASTRAL score component was missing. Endpoints were 5-year un-favorable functional outcome, defined as modified Rankin score 3-6, and 5-year mortality. For each outcome, the area under the receiver operating characteristics curve (AUC) was calculated; also, a multivariate Cox proportional hazards analysis was performed to investigate whether the ASTRAL score was an independent predictor of outcome. The Kaplan-Meier product limit method was used to estimate the probability of 5-year survival for each ASTRAL score quartile. Results: The AUC of the score to predict 5-year unfavorable functional was 0.89, 95%CI:0.88-0.91. In multivariate Cox proportional hazards analysis, the ASTRAL score was independently associated with 5-year unfavorable functional outcome hazard ratio (HR):1.09, 95%CI:1.08-1.10. The AUC for the ASTRAL score’s discriminatory power to predict 5-year mortality was 0.81 (95%CI:0.78- 0.83). In multivariate analysis, the ASTRAL score was independently associated with 5-year mor-tality (HR:1.09, 95%CI:1.08-1.10). During the 5-year follow-up, the probability of survival was sig-nificantly lower with increasing ASTRAL score quartiles (log-rank test <0.001). Conclusions: The ASTRAL score reliably predicts 5-year functional outcome and mortality in pa-tients with acute ischemic stroke.
Karger_ESC London_2013
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