22. European Stroke Conference Table 1: Results of multiple logistic regressions model for in-hospital mortality after stroke throm-bolytic 712 © 2013 S. Karger AG, Basel Scientific Programme therapy Factors Odds ratio 95% confidence in-terval ICH* 5.288 3.167-8.831 Age<50, reference 1 Age 51-60 0.634 0.353-1.141 Age 61-70 0.640 0.377-1.088 Age 71-80 1.045 0.645-1.693 Age>80 1.820 0.961-3.448 Sex (male vs. female) 0.796 0.582-1.088 CCI=0, reference 1 CCI=1 0.669 0.357-1.257 CCI=2 1.103 0.574-2.119 Weekend admission 0.963 0.682-1.360 tPA count of the hospital treating 1.000 0.997-1.003 AIS Neurology/neurosurgery specialist (yes vs. no) 0.884 0.622-1.257 (note: ICH=presence of code for intracerebral hemorrhage in the discharge diagnosis; CCI: Charlson co-morbidity index; *p-value< 0.05) Table 2: Results of multiple logistic regressions model for intracerebral hemorrhage after stroke thrombolytic therapy Factors Odds ratio 95% confidence in-terval Age<50, reference 1 Age 51-60 0.738 0.281-1.943 Age 61-70 1.506 0.674-3.366 Age 71-80 1.348 0.606-2.996 Age>80* 2.830 1.071-7.477 Sex (male vs. female) 0.809 0.516-1.269 CCI=0, reference 1 CCI=1 1.060 0.497-2.262 CCI=2 0.397 0.096-1.646 Weekend admission 0.942 0.572-1.553 tPA count of the hospital treating 0.992 0.986-0.998 AIS* Neurology/neurosurgery specialist (yes vs. no) 0.811 0.491-1.340 (note: CCI: Charlson co-morbidity index; *p-value< 0.05). 692 Acute stroke: clinical patterns and practice Stroke without ischemic lesions on the initial diffusion weighted image ~Fukuoka Stroke Reg-istry~ S. Fujimoto1, S. Mezuki2, T. Matsuki3, J. Jinnouchi4, T. Ishitsuka5, T. Kitazono6 Stroke Center, Steel Memorial Yawata Hospital, Kitakyushu, JAPAN1, Stroke Center, Steel Memorial Yawata Hospital, Kitakyushu, JAPAN2, Stroke Center, Steel Memorial Yawata Hospital, Kitakyushu, JAPAN3, Stroke Center, Steel Memorial Yawata Hospital, Kitakyushu, JAPAN4, Stroke Center, Steel Memorial Yawata Hospital, Kitakyushu, JAPAN5, Department of Medicine and Clini-cal Science, Graduate School of Medical Sciences Kyushu University, Fukuoka, JAPAN6 Background & Purpose: Diffusion weighted image (DWI) cannot always detect an acute ischemic lesion. We investigated the clinical features and outcome of stroke patients without an ischemic le-sion on the initial DWI. Subjects & Methods: Among the consecutive 3062 patients with sudden neurological deficits who were admitted to the 7 stroke centers in Fukuoka prefecture Japan within 24 hours after the symptom onset, 1731 patients with neurological deficits duration of 24 hours or more and pre-stroke modified Rankin scale (mRS) of 0 or 1 were included in the present study. We investigated clinical features, a neurological deterioration (a NIHSS score worsening of ≥1-point), and stroke recurrence. Results: Among 1731 patients, 102 (5.9%) had no ischemic lesions on DWI (DWI-negative Group), and other 1629 had ischemic lesions on DWI (DWI-positive Group). Atrial fibrillation (16.7% vs 29.2%, p=0.0064) and intracranial or extracranial cerebral artery stenosis of ≥50% in diameter (16.7% vs 36.3%, p<0.0001) were less frequent, and the initial NIH stroke scale score was lower (3.2±2.8 vs 5.8±5.9, p<0.0001) in the DWI-negative than the DWI-positive Group. Analysis on 285 patients who underwent transesophageal echocardiography (TEE), there was no significant differences in the frequency of complicated aortic arch lesions or patent foramen ovale between both groups. Stroke recurrence during the hospital days was relatively less frequent in the DWI-negative than the DWI-positive Group (2.9% vs 4.2%), however, stroke recurrence during 3 months after the onset was relatively more frequent in the DWI-negative than the DWI-posi-tive Group (7.8% vs 6.2%). A good outcome (modified Rankin scale of 0 or 1) on 3 months after the onset was more frequent in the DWI-negative than the DWI-positive Group (73.1% vs 57.7%, p=0.0035). Conclusions: Although a good outcome was more frequent in the DWI-negative than the DWI-positive Group, a stroke recurrence was not rare in the DWI-negative Group. Evaluations for the etiology of stroke, such as TEE, were required even in the stroke patients without ischemic le-sions on the initial DWI.
Karger_ESC London_2013
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