Three-Month Outcomes Comparison Among Wake-up and Non wake-up Ischemic Stroke in Phramongkutklao Hospital
Keywords:
ischemic stroke, non wake-up stroke, outcome, wake-up strokeAbstract
Background and Objective: Stroke symptoms noticed upon waking, wake-up ischemic stroke, account for up to a quarter of all acute ischemic stroke. Patients with wake-up ischemic stroke, however, are often excluded from thrombolytic therapy due to stroke onset time is unknown, and these patients revealed worse outcomes. The objective was to investigate the 3-month favorable outcomes between wake-up and non wake-up ischemic stroke, as defined by modified Rankin scale 0-2 (mRS 0-2).
Materials and Methods: A prospective cohort study was conducted at Neurological division, Phramongkutklao Hospital. All patients of age group 18 years or more presenting with acute ischemic stroke during August 2016 to May 2017 were enrolled. Demographic data, clinical presentation, severity, treatment, and outcomes were collected. Three-month favorable outcomes (mRS 0-2) were compared between wake-up and non-wake up ischemic stroke by applying binary logistic regression analysis.
Results: A total of 264 patients diagnosed with acute ischemic stroke were included, of which 100 (37.9%) were wake-up ischemic stroke. Wake-up stroke patients were at a significantly lower percentage to receive thrombolytic therapy (6% vs 14.6%, p-value=0.044). The 3-month favorable outcomes were similar between wake-up and non wake-up ischemic stroke patients, however, wake-up ischemic stroke patients tend to have less 3-month favorable outcome (60% vs 65.2%, p-value=0.431).
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