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22. European Stroke Conference 548 Epidemiology of stroke The stroke and cholelithiasis: a population-based longitudinal follow-up study C.Y. Wei1, P.J. Cheng2, W.T. Chung3, C.H. Chen4, Y.H. Yeh5, C.Y. Hsu6 Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Lugang Township, TAIWAN1, 2. Department of Hyperbaric Medicine Oxygen Therapy, Chang Bing Show Chwan Memorial Hospital, Lugang Township, Changhua County, TAIWAN2, Graduate Institute of Clini-cal Medicine, Taipei Medical University, Taipei, TAIWAN3, Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Lugang Township, Changhua County, TAIWAN4, Digestive Dis-ease Center, Chang Bing Show Chwan Memorial Hospital, Lugang Township, Changhua County, TAIWAN5, China Medical University Hospital, China Medical University, Taichung, TAIWAN6 Purpose: Gallstone disease (GD) and stroke share a number of risk factors including diabetes and hyperlipidemia. The nationwide population-based study was designed to estimate the risk of stroke following diagnosis with GD. Methods: Data were obtained from the Taiwan National Health Insur-ance Research Database. A total of 6,052 patients with a diagnosis of GD were included compared with 24,208 age- and gender-matched non-GD patients as the control cohort for assessing stroke risk applying Cox proportional hazards regressions. Results: During the 5 years follow-up period, 470 (13.9/1,000 person-years) strokes occurred among the GD patients and 1,653 (11.1/1,000 per-son- years) patients in the non-GD comparison cohort. The diagnosis of GD carried a higher risk for developing ischemic stroke with a hazard ratio (HR) of 1.26 (95% confidence interval CI 1.13 – 1.39, p < 0.0001). The stroke risk was highest in the younger age group (30 – 39) with HR of 4.87 (CI 1.49 – 15.9, p < 0.009) and declined with age (age 40 – 49: HR 1.66, CI 1.03 – 2.66, p <0.004; age 50 – 69: HR 1.37, CI 1.15 – 1.64, p<0.0005; age > 70: HR 1.31, CI 1.13 – 1.51, p< 0.0009). Female GD patients had higher stroke risk (HR 1.37; CI 1.18 – 1.59, p<0.001) than the male coun-terparts (HR 1.17; CI 1.01 – 1.35, p=0.0348). Conclusions: In this population-based longitudinal follow-up study, GD is associated with significantly higher stroke risk, especially in the younger age group and in female who demand closer attention for stroke prevention. 634 © 2013 S. Karger AG, Basel Scientific Programme 549 Epidemiology of stroke The ACROS Score: a simple clinical scale for prediction of death and dependency after isch-emic stroke. R. Muñoz1, B. Zandio2, B. Bermejo3, N. Aymerich4, M. Herrera5, S. Mayor6, J. Gallego7 Complejo Hospitalario de Navarra, Pamplona, SPAIN1, Complejo Hospitalario de Navarra, Pamplona, SPAIN2, Complejo Hospitalario de Navarra, Pamplona, SPAIN3, Complejo Hospitalario de Navarra, Pamplona, SPAIN4, Complejo Hospitalario de Navarra, Pamplona, SPAIN5, Complejo Hospitalario de Navarra, Pamplona, SPAIN6, Complejo Hospitalario de Navarra, Pamplona, SPAIN7 Background Making an accurate functional prognosis after suffering a stroke has always been a matter of im-mense relevance in routine clinical practice. The aim of this study was to develop a clinical predic-tion tool looking for the balance between simplicity and predictive ability taking into account pa-rameters certainly associated to stroke prognosis from an etiopathogenic perspective. Methods We analyzed data from a Hospital registry of 1077 patients (734 in the model cohort and 343 in the validation cohort) with ischemic stroke admitted between February 2009 and June 2011. We included demographics, risk factors, clinical and etiologic subtypes, clinical course, and follow-up prognosis. For statistical analysis, continuous variables were compared using Students t test and the χ2 test for nominal variables. A prediction model was developed using logistic regression. Results Overall 90-day mortality and dependence was 31.2% (model cohort) and 37.3% (validation cohort). In the final multivariate model, we included 5 clinical variables that were identified as independent predictors of unfavourable outcome (modified Rankin Score > 2 or death at 90 days): Age (A), Clin-ical severity of stroke defined by admission NIH Stroke Scale score (C), modified Rankin score at admission (R), Oxfordshire Community Stroke Project classification (O) and previous Stroke (S). The C statistic was 0.887 (IC 95% 0.861 – 0.912) in the model cohort and 0.836 (IC 95% 0.792 – 0.879) in the validation cohort. In our Score , the cut-off point that best discriminated primary end-point was 7 points (Sensitivity: 0.869 and Specificity: 0.701) (Table 1). Conclusions Although the evaluation of a patient who has suffered a stroke must be tailored and clinical judge-ment must dictate final decisions, predictive scores as the ACROS Score could assist clinicians in order to give counselling to patients and families as well as organizing rehabilitation facilities or es-timating public health needs.


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