Study of the Outcome Differences among the Ischemic Stroke Subtypes basedon TOAST Classifi cationat TribhuvanUniversity Teaching Hospital, Nepal
Journal Title: Nepal Journal of Neuroscience - Year 2018, Vol 15, Issue 2
Abstract
The objective of this study was to explore the outcome differen cesamong is chemic stroke sub types based on “Trial of ORG 10172 in Acute Stroke Treatment (TOAST)” system in a tertiary referral hospital. A hospital based prospectiv elongitudinal study was conducted involving 182 patients. Modifi ed Rank in Scale (MRS) was used to assess functional out come, Kaplan-Meierproduct- limit method and Coxproportional hazards regression analys is were used to evaluate rates and identify predictors of survival and recurrent stroke. MRS were statistically different across stroke subtypesat 30 days and 6 months (p<0.0001 and (p<0.0001) respectively). Lacunar stroke was associated with milder defi cits. Estimated rates of recurrent stroke were signifi cantly differentat 30 days (p<0.0001)and at 6 months (p=0.009). Before adjusting forage, sex, stroke severity, and diabetes mellitus, infarct subtype was not an independent determinant of recurrent stroke within 30 days (p=0.057);but was at 6months (p=0.024), how ever after same adjustment it was independent determinant both at 30 days (p=0.030) and at 6 months (p=0.025). Estimated death rates were signifi cantly different both at30 days (p=0.026) and at 6 months (p=0.009).Ischemic stroke subtype wasan independent determinant of 6-month survival both before (p=0.016) and after (p=0.027) adjustment for different parameters; however, was not of 30-day survival both before (p=0.054) and after (p=0.993) same adjustment. Early recurrencerates were highest among largeartery atherosclerotic stroke. Lacunar strokehas betterpost stroke functional status. Survival is poorest among cardioembolic stroke
Authors and Affiliations
Dr Ragesh Karn
Keywords
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