In-Hospital and Post-Discharge Recovery after Acute Ischemic Stroke: a Nationwide Multicenter Stroke Registry-base Study
10.3346/jkms.2019.34.e240
- Author:
Min Uk JANG
1
;
Jihoon KANG
;
Beom Joon KIM
;
Jeong Ho HONG
;
Min Ju YEO
;
Moon Ku HAN
;
Byung Chul LEE
;
Kyung Ho YU
;
Mi Sun OH
;
Kyung Chan CHOI
;
Sang Hwa LEE
;
Keun Sik HONG
;
Yong Jin CHO
;
Jong Moo PARK
;
Jae Kwan CHA
;
Dae Hyun KIM
;
Tai Hwan PARK
;
Kyung Bok LEE
;
Soo Joo LEE
;
Jun LEE
;
Joon Tae KIM
;
Dong Eog KIM
;
Jay Chol CHOI
;
Juneyoung LEE
;
Ji Sung LEE
;
Philip B GORELICK
;
Hee Joon BAE
Author Information
1. Department of Neurology, Hallym University College of Medicine, Chuncheon, Korea.
- Publication Type:Multicenter Study
- Keywords:
Registries;
Stroke;
Brain Infarction: Recovery of Function;
Prognosis
- MeSH:
Blood Glucose;
Blood Pressure;
Humans;
Incidence;
Logistic Models;
National Institutes of Health (U.S.);
Odds Ratio;
Prognosis;
Registries;
Smoke;
Smoking;
Stroke
- From:Journal of Korean Medical Science
2019;34(36):e240-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Using data from a large national stroke registry, we aimed to investigate the incidence and determinants of in-hospital and post-discharge recovery after acute ischemic stroke and the independence of their occurrence. METHODS: In-hospital recovery was defined as an improvement of 4 points or > 40% in the National Institutes of Health Stroke Scale (NIHSS) score from admission to discharge. Post-discharge recovery was defined as any improvement in the modified Rankin Scale (mRS) score from discharge to 3 months after stroke onset. Two analytic methods (multivariate and multivariable logistic regression) were applied to compare the effects of 18 known determinants of 3-month outcome and to verify whether in-hospital and post-discharge recovery occur independently. RESULTS: During 54 months, 11,088 patients with acute ischemic stroke meeting the eligibility criteria were identified. In-hospital and post-discharge recovery occurred in 36% and 33% of patients, respectively. Multivariate logistic regression with an equality test for odds ratios showed that 7 determinants (age, onset-to-admission time, NIHSS score at admission, blood glucose at admission, systolic blood pressure, smoking, recanalization therapy) had a differential effect on in-hospital and post-discharge recovery in the way of the opposite direction or of the same direction with different degree (all P values < 0.05). Both in-hospital and post-discharge recovery occurred in 12% of the study population and neither of them in 43%. The incidence of post-discharge recovery in those with in-hospital recovery was similar to that in those without (33.8% vs. 32.7%, respectively), but multivariable analysis showed that these 2 types of recovery occurred independently. CONCLUSION: Our findings suggest that, in patients with acute ischemic stroke, in-hospital and post-discharge recovery may occur independently and largely in response to different factors.
