London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 331 96 Stroke prognosis RELATIONSHIP BETWEEN PULSATILITY INDEX AND CLINICAL COURSE OF ACUTE ISCHEMIC STROKE AFTER THROMBOLYTIC TREATMENT N. Uzuner1, A.O. Ozdemir2 Eskisehir Osmangazi University, Eskisehir, TURKEY1, Eskisehir Osmangazi University, Eskise-hir, TURKEY2 Background: The aim of our study was to evaluate whether there is an association between the PI of the middle cerebral artery (MCA) measured by TCD and short and long term clinical and functional outcomes in ischemic stroke patients. Methods: Forty-eight patients with acute ischemia in the MCA territory who achieved complete re-canalization after the administration of intravenous thrombolytic treatment within 4.5 hours after the onset of symptoms were included in the study. The TCD was applied to patients at baseline and 1 hour after the iv rt-PA bolus and their MCA blood flow parameters including blood flow velocities and pulsatility index (PI) were recorded. Clinical and functional outcomes were assessed by Nation-al Institutes of Health Stroke Scale (NIHSS) scores and modified Rankin scores (mRS) respectively. Results: One hour after the iv rt-PA bolus, end-diastolic velocity was measured as 27.8 cm/s and PI was measured as 1.1 on complete recanalized MCA according to the TIBI score, and the baseline NIHSS score was 13.2. Significant negative correlations were found between the end-diastolic ve-locity and NIHSS (4.3) score at 24 hours (p=0.002), NIHSS score (2.6) at 3 months (p=0.032), and mRS (1.2) at 3 months (p<0.033). Significant positive correlations were found between the PI value and NIHSS score at 24 hours (p=0.004), NIHSS score at 3 months (p=0.003), and mRS at 3 months (p<0.001). For a favorable prognosis the cut-off value for PI in predicting a favorable prognosis (mRS equal or less than 1) and a good prognosis (mRS equal or less than 2) might be less than or equal to 1.1 (sensitivity is 80% and specificity is 87.5%) and less than or equal to 1.4 (sensitivity is 100% and specificity is 66.7%) respectively. Conclusion: Among blood flow parameters that are measured by TCD as a simple method of exam-ination in acute ischemic stroke, pulsatility index may play a role in predicting a good functional and clinical outcome after thrombolytic therapy in acute ischemic stroke patients. 97 Stroke prognosis White matter lesions predict hospital admissions due to trauma after ischemic stroke G. Sibolt1, S. Curtze2, S. Melkas3, T. Pohjasvaara4, M. Kaste5, P. Karhunen6, N.K.J. Oksala7, T. Strandberg8, T. Erkinjuntti9 Department of Neurology, Helsinki University Central Hospital and Department of Neurolog-ical Sciences, University of Helsinki, Helsinki, FINLAND1, Department of Neurology, Helsinki University Central Hospital and Department of Neurological Sciences, University of Helsinki, Hel-sinki, FINLAND2, Department of Neurology, Helsinki University Central Hospital and Department of Neurological Sciences, University of Helsinki, Helsinki, FINLAND3, Department of Neurology, Helsinki University Central Hospital and Department of Neurological Sciences, University of Hel-sinki, Helsinki, FINLAND4, Department of Neurology, Helsinki University Central Hospital and Department of Neurological Sciences, University of Helsinki, Helsinki, FINLAND5, School of Med-icine, Forensic Medicine, University of Tampere and the Laboratory Centre Research Unit, Tampere University Hospital, Tampere, FINLAND6, Division of Vascular Surgery, Department of Surgery, Tampere University Hospital, Tampere, FINLAND7, Department of Medicine, Geriatric Clinic, Uni-versity of Helsinki and University Central Hospital, Helsinki, FINLAND8, Department of Neurol-ogy, Helsinki University Central Hospital and Department of Neurological Sciences, University of Helsinki, Helsinki, FINLAND9 Background: Cerebral white matter lesions (WMLs) are a surrogate for small-vessel disease. They have been shown to be associated to decreasing mobility, gait instability, and falls. The objective of this study was to investigate whether WMLs of the brain are associated with increased incidence of hospital admissions due to trauma in a cohort of stroke patients. Methods: We followed-up for 12 years 383 consecutive patients from the SAM cohort with ischemic stroke admitted to Helsinki University Central Hospital. Hip-fractures, traumatic injuries, survival data, and causes of death were reviewed from national register data. WMLs on MRI were rated and dichotomized as none to mild and moderate to severe. The data were analysed using Kaplan-Meier plots (log-rank) and the Cox multivariable hazards models to assess hazard ratios (HR) with their 95% confidence intervals (CI). A subanalysis for patients <65 years was performed. Results: There were more hip-fractures in the moderate to severe than in the none to mild WMLs group (13.5% vs 6.5%; log- rank p=0.01) during the 12-year follow-up. There were also more hospi-tal admissions due to trauma in the moderate to severe than in the none to mild WMLs group (23.4% vs 7.7%; log-rank p=0.02) among patients <65 years. Only age was a significant independent predictor of hip-fractures (HR 1.06; 95% CI, 1.01-1.11) and for traumatic injuries (HR 1.04; 95% CI, 1.01-1.08) after adjusting for age, gender, and moderate to severe WMLs lesions in the Cox analyses of the whole cohort. Moderate to severe WMLs in-dependently predicted hospital admissions due to traumatic injuries (HR 5.24; 95% CI 1.25-21.9) among patients <65 years . Conclusions: Younger stroke patients with more than mild WMLs are at high risk to suffer serious traumatic injuries requiring hospital treatment.
Karger_ESC London_2013
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