Shahid Rizwana, Zafar Azra, Nazish Saima, Shariff Erum, Alshamrani Foziah, Aljaafari Danah, Soltan Nehad Mahmoud, Alkhamis Fahad A, Albakr Aishah Ibrahim, Alabdali Majed, Saqqur Maher
Department of Neurology, College of Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Medicine and Neurology, University of Alberta, Edmonton, Canada.
Ann Afr Med. 2024 Oct 1;23(4):548-555. doi: 10.4103/aam.aam_22_23. Epub 2024 Aug 19.
As stroke is still considered a significant cause of mortality and morbidity, it is crucial to find the factors affecting the outcome in these patients. We aimed to interpret the various clinical and investigational parameters and establish their association with the outcome in stroke patients.
This is a retrospective, cross-sectional study, conducted in the Department of Neurology between June 2019 to November 2021. The study involved the review and analysis of medical records pertaining to 264 patients, admitted with the diagnosis of stroke. Various clinical, radiological, and electroencephalographic (EEG) patterns in stroke patients were analyzed and their association with outcome was established. The association between the studied variables was performed by the logistic regression (LR) and presented as odds ratio (OR) and 95% confidence interval (CI).
The study sample consisted of 264 patients. Males comprised 165 (62.5%) with the mean participant age of 57.17 ± 18.7 3 years (range: 18-94). Patients younger than 50 years had a better likelihood of a good outcome in comparison to patients older than 50. The admission location was the most significant factor in predicting the outcome ( P = 0.00) in favor of inpatient department and outpatient department (OPD), in contrast to patients admitted directly to intensive care unit (ICU). Normal EEG was associated with good outcome ( P = 0.04; OR, 3.3; CI, 1.01-10.88) even after adjustment of the confounders, whereas patients having marked EEG slowing had a poor outcome ( P = 0.05; OR, 2.4; CI, 0.65-8.79). Among the clinical parameters, hemiparesis ( P = 0.03), trauma ( P = 0.01), generalized tonic-clonic seizures (GTC) ( P = 0.00), and National Institutes of Health Stroke Scale of more than 4 were more likely associated with a poor outcome as well as the presence of intracranial hemorrhage (ICH) or infarction in the cortical and cortical/subcortical locations were associated with poor outcomes. After adjustment of confounders, the factors found to have prognostic significance in favor of good outcomes were inpatients or OPD referrals and normal EEG while direct admission to ICU, marked slowing on EEG, and presence of ICH were found to be associated with poor outcome.
Certain patterns are predictive of good or worse outcomes in stroke patients. Early identification of these factors can lead to early intervention, which in turn might help in a better outcome. The results of the study, therefore, have some prognostic significance.
由于中风仍然被认为是导致死亡和发病的重要原因，找出影响这些患者预后的因素至关重要。我们旨在解读各种临床和研究参数，并确定它们与中风患者预后的关联。
这是一项回顾性横断面研究，于2019年6月至2021年11月在神经内科进行。该研究涉及对264例诊断为中风的住院患者的病历进行回顾和分析。分析了中风患者的各种临床、放射学和脑电图（EEG）模式，并确定了它们与预后的关联。通过逻辑回归（LR）分析所研究变量之间的关联，并以比值比（OR）和95%置信区间（CI）表示。
研究样本包括264例患者。男性有165例（62.5%），参与者的平均年龄为57.17±18.73岁（范围：18 - 94岁）。与50岁以上的患者相比，50岁以下的患者有更好的预后可能性。入院地点是预测预后的最重要因素（P = 0.00），有利于住院部和门诊部（OPD），而直接入住重症监护病房（ICU）的患者预后较差。即使在调整混杂因素后，正常脑电图与良好预后相关（P = 0.04；OR，3.3；CI，1.01 - 10.88），而脑电图明显减慢的患者预后较差（P = 0.05；OR，2.4；CI，0.65 - 8.79）。在临床参数中，偏瘫（P = 0.03）、创伤（P = 0.01）、全身强直 - 阵挛性发作（GTC）（P = 0.00）以及美国国立卫生研究院卒中量表评分超过4分更有可能与不良预后相关，并且皮质和皮质/皮质下部位存在颅内出血（ICH）或梗死也与不良预后相关。在调整混杂因素后，发现有利于良好预后的具有预后意义的因素是住院患者或OPD转诊以及正常脑电图，而直接入住ICU、脑电图明显减慢和存在ICH与不良预后相关。
某些模式可预测中风患者的预后好坏。早期识别这些因素可导致早期干预，这反过来可能有助于获得更好的预后。因此，该研究结果具有一定的预后意义。
