Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Department of Neurology, University Hospital in Krakow, Poland.
Neurol Neurochir Pol. 2021;55(3):295-299. doi: 10.5603/PJNNS.a2021.0037. Epub 2021 May 5.
The 4C Mortality Score was created to predict mortality in hospitalised patients with COVID-19 and has to date been evaluated only in respiratory system disorders. The aim of this study was to investigate its application in patients with COVID-19-associated acute ischaemic stroke (AIS).
COVID-19 is a risk factor for AIS. COVID-19-associated AIS results in higher mortality and worse functional outcome. Predictors of functional outcome in COVID-19-associated AIS are required.
This was a retrospective observational study of patients with AIS hospitalised in seven neurological wards in Małopolska Voivodship (Poland) between August and December 2020. We gathered data concerning the patients' age, sex, presence of cardiovascular risk factors, type of treatment received, and the presence of stroke-associated infections (including pneumonia, urinary tract infection and infection of unknown source). We calculated 4C Mortality Score at stroke onset, and investigated whether there was a correlation with neurological deficit measured using the National Health Institute Stroke Scale (NIHSS) and functional outcome assessed using the modified Rankin Scale (mRS) at discharge.
The study included 52 patients with COVID-19-associated AIS. The 4C Mortality Score at stroke onset correlated with mRS (rs = 0.565, p < 0.01) at discharge. There was also a statistically significant difference in the mean 4C Mortality Score between patients who died and patients who survived the stroke (13.08 ± 2.71 vs. 9.85 ± 3.47, p = 0.04).
4C Mortality Score predicts functional outcome at discharge in COVID-19-associated AIS patients.
4C 死亡率评分旨在预测 COVID-19 住院患者的死亡率，迄今为止仅在呼吸系统疾病中进行了评估。本研究旨在探讨其在 COVID-19 相关性急性缺血性脑卒中（AIS）患者中的应用。
COVID-19 是 AIS 的一个危险因素。COVID-19 相关性 AIS 导致更高的死亡率和更差的功能结局。需要预测 COVID-19 相关性 AIS 的功能结局。
这是一项回顾性观察性研究，纳入了 2020 年 8 月至 12 月期间在波兰小波兰省 7 个神经科病房住院的 AIS 患者。我们收集了患者的年龄、性别、心血管危险因素、接受的治疗类型以及与中风相关的感染（包括肺炎、尿路感染和不明来源的感染）等数据。我们在发病时计算了 4C 死亡率评分，并研究了其与使用国立卫生研究院卒中量表（NIHSS）测量的神经功能缺损和使用改良 Rankin 量表（mRS）评估的功能结局之间的相关性。
本研究纳入了 52 例 COVID-19 相关性 AIS 患者。发病时的 4C 死亡率评分与出院时的 mRS（rs = 0.565，p < 0.01）相关。死亡患者和存活患者的 4C 死亡率评分平均值之间也存在统计学差异（13.08 ± 2.71 与 9.85 ± 3.47，p = 0.04）。
4C 死亡率评分可预测 COVID-19 相关性 AIS 患者出院时的功能结局。
