The prognostic value of deep earlobe creases in patients with acute ischemic stroke

Jiaping Xu; Lixuan Wang; Chunqing Zhang; Jiayun Wang; Danni Zheng; Yaqian Huang; Xia Zhang; Shoujiang You; Yongjun Cao; Chun-Feng Liu

doi:10.3389/fcvm.2023.1096044

The prognostic value of deep earlobe creases in patients with acute ischemic stroke

Front Cardiovasc Med. 2023 May 30:10:1096044. doi: 10.3389/fcvm.2023.1096044. eCollection 2023.

Authors

Jiaping Xu^#¹, Lixuan Wang^#^{1

2}, Chunqing Zhang^#¹, Jiayun Wang^{1

3}, Danni Zheng⁴, Yaqian Huang¹, Xia Zhang¹, Shoujiang You^#¹, Yongjun Cao^#^{1

5}, Chun-Feng Liu^{1

5}

Affiliations

¹ Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
² Department of Neurology, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
³ Department of Neurology, Qinghai University Affiliated Hospital, Xining, China.
⁴ The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
⁵ Institutes of Neuroscience, Soochow University, Suzhou, China.

^# Contributed equally.

Abstract

Background and purpose: Data on earlobe crease (ELC) among patients with acute ischemic stroke (AIS) are limited. Here, we determined the frequency and characteristics of ELC and the prognostic effect of ELC among AIS patients.

Methods: A total of 936 patients with acute AIS were enrolled during the period between December 2018 and December 2019. The patients were divided into those without and with ELC, unilateral and bilateral ELC, and shallow and deep ELC, according to the photographs taken of the bilateral ears. Logistic regression models were used to estimate the effect of ELC, bilateral ELC, and deep ELC on poor functional outcomes at 90 days (a modified Rankin Scale score ≥2) in AIS patients.

Results: Among the 936 AIS patients, there were 746 (79.7%) patients with ELC. Among patients with ELC, there were 156 (20.9%) patients with unilateral ELC and 590 (79.1%) with bilateral ELC and 476 (63.8%) patients with shallow ELC and 270 (36.2%) with deep ELC. After adjusting for age, sex, baseline NIHSS score, and other potential covariates, patients with deep ELC were associated with a 1.87-fold [odds ratio (OR) 1.87; 95% confidence interval (CI), 1.13-3.09] and 1.63-fold (OR 1.63; 95%CI, 1.14-2.34) increase in the risk of poor functional outcome at 90 days in comparison with those without ELC or shallow ELC.

Conclusion: ELC was a common phenomenon, and eight out of ten AIS patients had ELC. Most patients had bilateral ELC, and more than one-third had deep ELC. Deep ELC was independently associated with an increased risk of poor functional outcome at 90 days.

Keywords: acute ischemic stroke; characteristics; earlobe crease; frequency; prognostic value.

Grants and funding

This work was supported in part by grants from the National Natural Science Foundation of China (81901198 and 82171296), the Gusu Health Talents Program (GSWS2020029), the Discipline Construction Program of the Second Affiliated Hospital of Soochow University (XKTJ-XK202001 and XKTJ-TD202004), and the Suzhou Technology Development Program (SLT201924). This work was also partly supported by the 6th Jiangsu Province 333 High Level Talents Training Project.