Key result
Moderate to severe white matter lesions were an independent risk factor for poor 3-month functional outcome (OR 4.105) in patients with acute cardioembolic stroke without reperfusion therapy.
Why the study?
Few studies have investigated the influence of white matter lesions on the prognosis of acute cardioembolic stroke.
Do moderate to severe white matter lesions predict poor functional outcomes in patients with acute cardioembolic stroke without reperfusion therapy?
Observational (n=251)
No
Do moderate to severe white matter lesions predict poor functional outcomes in patients with acute cardioembolic stroke without reperfusion therapy?
Moderate to severe white matter lesions independently predict poor 3-month functional outcomes in patients with acute cardioembolic stroke who do not receive reperfusion therapy.
Answers are grounded in this paper and cite their sources.
May inform early prognostication in cardioembolic stroke; hypothesis-generating and requires prospective validation before guiding care.
BACKGROUND: Few studies have investigated the influence of white matter lesions (WMLs) on the prognosis of acute cardioembolic stroke (CES). We aimed to explore the role of WMLs in predicting 3-month prognosis of CES without reperfusion therapy. METHODS: A number of 251 acute CES patients without reperfusion therapy at a single center were retrospectively recruited. The severity of WMLs was evaluated by Fazekas scale and patients were divided into mild WMLs group (188 cases, Fazekas ≤ 2 points) and moderate to severe WMLs group (63 cases, Fazekas ≥ 3 points) accordingly. General data and clinical features of the two groups were compared. Functional outcomes of patients were followed up for 3 months using the modified Rankin scale (mRS) and patients were divided into poor outcome group (mRS ≥ 3) and favorable outcome group (mRS ≤ 2). The effect of WMLs on the prognosis was identified by binary logistic regression. RESULTS: Patients in moderate to severe WMLs group were older (P < 0.001). Also, they had higher baseline National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001) and elevated incidence of asymptomatic cerebral hemorrhage (P = 0.040) and stroke associated pneumonia (P = 0.001) than those in mild WMLs group. At 3 months, there were 100 cases in the poor outcome group. Patients in poor outcome group had higher baseline NIHSS score, increased proportion of moderate to severe WMLs, and elevated incidence of stroke associated pneumonia than those in favorable outcome group (P < 0.001). Binary logistic regression analysis showed that moderate to severe WMLs (odds ratio [OR] = 4.105, 95 % confidence interval [CI] = 1.447-11.646), baseline NIHSS score (OR = 1.368, 95 % CI = 1.240-1.511), and stroke-associated pneumonia (OR = 4.840, 95 %CI = 1.889-12.400) were independent risk factors for poor outcome. CONCLUSIONS: Moderate to severe WMLs is an independent risk factor for prognosis of CES patients without reperfusion therapy.
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Guo et al. (2021) conducted an observational in Acute cardioembolic stroke (n=251). Moderate to severe white matter lesions vs. Mild white matter lesions was evaluated on Poor functional outcome (mRS ≥ 3) at 3 months (OR 4.105, 95% CI 1.447-11.646, p=0.008). Moderate to severe white matter lesions were an independent risk factor for poor 3-month functional outcome (OR 4.105) in patients with acute cardioembolic stroke without reperfusion therapy.
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