Smoking was associated with a significantly higher risk of 3-month poor functional outcomes in patients with severe stroke following intravenous thrombolysis (adjusted OR 4.216; 95% CI 1.236-14.385).
Cohort
Does smoking affect poor functional outcome and mortality at 3 months in patients receiving intravenous thrombolysis for stroke?
Stroke severity significantly modifies the association between smoking and 3-month functional outcomes after intravenous thrombolysis, with smoking worsening outcomes specifically in severe stroke.
Effect estimate: Adjusted OR 4.216 (95% CI 1.236-14.385)
Absolute Event Rate: 81.6% vs 55.9%
OBJECTIVE: To our knowledge, no previous studies have investigated the impact of stroke severity on the smoking paradox after intravenous thrombolysis (IVT). We aimed to explore the contribution of stroke severity to the association between smoking and stroke prognosis after IVT. METHODS: We enrolled consecutive patients who received IVT within 4.5 hours from stroke onset. A logistic regression model was used to estimate the unadjusted and adjusted odds ratios (ORs) with their 95% confidence intervals (CIs) for poor functional outcome and mortality at 3 months. RESULTS: Among patients with moderate stroke, smokers experienced a lower risk of 3-month poor outcomes than non-smokers (33.0% vs. 44.4%, unadjusted OR: 0.616; 95% CI: 0.402-0.945). However, among those with severe stroke, smokers had a higher risk of 3-month poor outcomes than non-smokers (81.6% vs. 55.9%, unadjusted OR: 3.496; 95% CI: 1.207-10.127). After adjustment, the negative correlation between smoking and 3-month poor outcome following IVT lost statistical significance in patients with moderate stroke (OR: 0.677 95% CI: 0.418-1.097). However, smoking remained a risk factor for 3-month poor outcomes in patients with severe stroke (OR: 4.216 95% CI: 1.236-14.385). We also observed a significant interaction between smoking and stroke severity with regard to the risk of poor functional outcomes (p=0.023). However, no such interaction influenced mortality (p=0.901). CONCLUSION: Stroke severity affects the association between smoking and 3-month clinical functional outcomes following IVT.
Yang et al. (Fri,) conducted a cohort in Stroke. Smoking vs. Non-smoking was evaluated on Poor functional outcome at 3 months (severe stroke subgroup) (Adjusted OR 4.216, 95% CI 1.236-14.385). Smoking was associated with a significantly higher risk of 3-month poor functional outcomes in patients with severe stroke following intravenous thrombolysis (adjusted OR 4.216; 95% CI 1.236-14.385).
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