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KMID : 0390320160260020001
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Chungbuk Medical Journal
2016 Volume.26 No. 2 p.1 ~ p.9
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Unclear-onset Ischemic Stroke: Clinical Features and Functional Outcome
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Choi In-Young
Lee Hye-Lim
Yeo Min-Ju
Kim Ji-Seon
Lee Sung-Hyun
Lee Sang-Soo
Shin Dong-Ick
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Abstract
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Purpose: Unclear-onset strokes occur in about one-fourth of patients with ischemic stroke. Several recent studies have suggested thrombolytic therapy may be helpful in unclear-onset strokes, however, the clinical features and functional outcome of unclear-onset strokes are largely unknown. In this study, we evaluated outcomes among patients with unclear-onset ischemic strokes compared to those with clear onset ischemic stroke.
Materials and Methods: The retrospective analysis reviewed 250 consecutive patients with acute ischemic stroke who were admitted between September 2012 and August 2013. Risk factors related to stroke and several laboratory data were compared between clear-onset ischemic stroke group and unclear-onset ischemic stroke group. Stroke severity was evaluated by National Institutes of Health Stroke Scale score. The primary outcome measure was the median modified Rankin Scale at 3months. Other outcome measures were modified Rankin scale of 0 to 2, and mortality at 3months.
Results: No significant differences were found in terms of sex, age, vascular risk factors and stroke subtypes between the two groups. Hematocrit was found to be higher in unclear-onset stroke group (mean±SD; 40.4±6.1 versus 38.6±5.6; p=0.032). The initial National Institutes of Health Stroke Scale score of patients with unclear-onset ischemic stroke was significantly higher than that of their clear-onset ischemic stroke counterparts (median [interquartile range]; 9[3 to 14] versus 4[1 to 5]; p=0.000). The functional outcome of unclear-onset ischemic stroke group was worse than that of clear-onset ischemic stroke group (median [interquartile range]; 3[1 to 6] versus 1[0 to 2]; p=0.000).
Conclusion: Although the baseline characteristics of the unclear-onset ischemic stroke group were similar to those of persons enrolled in the clear-onset ischemic stroke group, their outcomes were much poorer. We suggest that clinical approach for the identification of unclear onset ischemic stroke patients who can potentially benefit from recanalization therapy is essential.
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KEYWORD
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functional outcome, 3months-modified Rankin Scale, hematocrit, unclear-onset ischemic stroke
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