Trends in clinical features and early outcome in patients with acute cardioembolic stroke subtype over a 19-year period

Neurol India. 2012 May-Jun;60(3):288-93. doi: 10.4103/0028-3886.98513.

Abstract

Objectives: To assess changing trends in clinical characteristics and early outcome of patients with acute cardioembolic stroke (ACS) over a 19-year period.

Materials and methods: Data of 575 patients with first-ever ACS included in the Sagrat Cor Hospital of Barcelona Stroke Registry were analyzed. Changing trends for 1986-1992, 1993-1998, and 1999-2004 periods were compared.

Results: A statistically significant increase (P < 0.001) in the age of patients (74.6 years in 1986-1992 vs. 81.4 years in 1999-2004) and the percentage of patients older than 85 years of age (16% vs. 38.2%) was observed. Patients with hypertension increased from 40.5 to 60.8% (P = 0.001) as were patients with diabetes, chronic bronchitis, and obesity (P = NS). The median length of hospital stay decreased from 18 to 12 days (P = 0.031) and prolonged hospital stay (>12 days) from 18.3 to 13.1 (P = 0.033). In-hospital death rate remained around 20%.

Conclusions: ACS continues to be a severe ischemic stroke subtype with high risk of in-hospital death. The lack of improvement in the early prognosis over a 19-year period may be explained by an increase in the prevalence of major cardiovascular risk factors and progressive aging of the population.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / etiology
  • Cardiovascular Diseases / epidemiology*
  • Cohort Studies
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Stroke / complications
  • Stroke / epidemiology*
  • Survival Rate
  • Tomography, X-Ray Computed