Predictive factors of outcome and stroke recurrence in patients with unilateral atherosclerosis-related internal carotid artery occlusion

Neurol India. 2008 Apr-Jun;56(2):173-8. doi: 10.4103/0028-3886.41996.

Abstract

Background: Clinical outcome of internal carotid artery (ICA) occlusion is highly variable and the reason is uncertain.

Aim: To study the predictive factors of clinical outcome and stroke recurrence in patients with ischemic stroke associated with unilateral atherosclerosis-related ICA occlusion.

Settings and design: Prospective study in neurology department of a single hospital.

Materials and methods: We prospectively studied 66 patients who suffered from first-ever ischemic stroke associated with unilateral atherosclerosis-related ICA occlusion over a period of two years. The end point was death or stroke recurrence.

Statistical analysis: Chi-square or Fisher's exact test was used to analyze predictors of early functional outcome. Multivariate analysis was used to analyze predictors of death or stroke recurrence within two years.

Result: Higher age (>or=70 years) predicted a worse functional outcome (P=0.049). Total anterior circulation syndrome (TACS) was associated with a poor functional outcome (P<0.001), but lacunar syndrome had a better outcome (P=0.001). Stroke in evolution predicted a poor outcome (P=0.001), while those with symptom improvement had a better outcome (P=0.016). Pneumonia predicted a poor outcome (P=0.021). Five patients expired and 22 patients suffered from recurrent stroke in the following 24 months. Previous transient ischemic attack (TIA) and anemia were associated with a higher risk of death or recurrent stroke within two years (P=0.036, P=0.012).

Conclusion: High age, TACS, stroke in evolution and pneumonia were predictors for poor functional outcome. Previous TIA and anemia were predictors for death and recurrent stroke within two years.

MeSH terms

  • Aged
  • Carotid Artery Diseases / complications*
  • Cerebral Angiography
  • Chi-Square Distribution
  • Female
  • Functional Laterality / physiology
  • Humans
  • Intracranial Arteriosclerosis / complications*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Recurrence
  • Risk Factors
  • Stroke / etiology*
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Treatment Outcome