Relationship between the ischemic stroke subtypes and risk factors included clinical outcome from Prasat Neurological Institute stroke registry
Keywords:
Stroke, Stroke subtypesAbstract
Background and Purpose - The etiologies of ischemic stroke affect prognosis, outcomes and treatments of patients. The objective of this study is to look for the differences in risk factors, stroke severities, complications, treatments and prognosis in each stroke subtype. Methods - We prospectively studied 140 consecutive patients with acute ischemic stroke [37.9% women, median age of 61.5 (53-72) years] from June, 2013 to August, 2013. All patients were categorized by TOAST (Trial of Org 10172 in Acute Stroke Treatment) stroke subtypes, based on the MRI Imaging; Small vessel Atherosclerosis (SAO), Large vessel Atherosclerosis (LAA), Cardiac Embolism (CE), Other Determined etiology (OD) and other Undetermined etiology (UND). Results - This study found that the age, severity, complications, treatment strategies, costs and outcomes were significantly different in each subtype of stroke (p< 0.001). SAO (45%) was most often found in our study. Patients with CE were older (68.5 years old) than those with other subtypes and patients with OD were the youngest (mean age of 39). Prevalence of obesity (33.3%), complications and also higher cost were found more common in patients with CE than those of SAO and LAA. The treatments with intravenous thrombolytic (11.1%) and anticoagulant (83.3%) were prescribed more common in patients with CE. The good clinical outcome (mRS 0-2) was more often found in SAO subtype than in LAA and CE subtype. Conclusions - Risk factor profiles, treatment, clinical outcome and prognosis of each stroke subtype are different. Treatments and prevention should be optimized for each subtype.
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