| Objective To study the etiology of wake-up Stroke, and the influence of the early functional outcome of wake-up Stroke for patients. So as to guide the secondary prevention and provide objective basis to wake up stroke prognosis evaluation.Methods Consecutive patients of acute cerebral infarction who were admitted to hospital were collected from the department of neurology of the affiliated Hefei hospital of Anhui Medical University from June 2012 to June 2014. According to time since stroke onset is different,they were divided into woke up stroke group and non wake up stroke group.Demographics and imaging data were compared between two groups to study for predictors for woke up stroke.All the strokes were Scored with a charge National Institutes of Health Stroke Scale(NIHSS) and discharge modified Rankin Scale (mRS).according to the discharge of scores of the mRS,They were divided into either a Unfavorable Outcome(≥2 points) or Favorable Outcome group. So as to evaluate two groups of patients with early prognosis.Results A total of 526 patients with acute cerebral infarction were enrolled.we excluded patients with the following conditions:missing the time of stroke onset and circumstances of stroke onset, lack of records regarding the stroke’s severity,and patients with hemorrhagic stroke. Therefore, our study population consisted of 420 patients.266 cases were males,154 cases were females.The mean age of the cases was (69±12)years,Of these patients 103 were diagnosed with woke -up stroke, and other 317 patients were among non wake -up stroke.1.The etiology:Univariate analysis revealed the proportion of large artery atherosclerosis (23.3%vs34.7%, P=0.031) and fasting blood-glucose (6.±2.1对 6.6±3.7, P=0.012) were significantly lower than that in non wake -up stroke group.However, compared with non wake -up stroke group,the proportion of small vessel occlusion (21.4%vs11.0%, P=0.008),triglyceride (2.0±2.1vs1.8±1.0, P<0.001) and the history of atrial fibrillation (25.2%vs11.8%, P=0.015) were significantly higher than that in non wake -up stroke group.Logistic regression analysis identified that the stroke subtype,fasting blood-glucose,triglyceride and triglycerid were not etiology for wake -up stroke.2.The prognosis:Univariate analysis revealed the proportion of wake -up stroke (31.2%vsl8.9%, P=0.003),the history of atrial fibrillation (24.0%vs11.8%, P=0.001) and the charge of scores of the NIHSS (11.8±3.8对5.0±2.8, P<0.001) were significantly higher than in favorable Outcome group. However, compared with unfavorable outcome group, the onset-to-admission time (20.9±22.9vs 16.6± 17.4. P=0.004) in patients with favorable outcome group were significantly higher.Logistic regression analysis identified that the charge of scores of the NIHSS (OR 2.007,95% CI:1.749-2.304; P<0.001) was independent predictor for the prognosis of stroke.Conclusion From our study, we documented that the etiology did not differ between the two cohorts.however woke-up stroke was associated with worse short-term outcomes after ischemic stroke, the charge of scores of the NIHSS significantly higher than in non wake -up stroke group and the discharge of scores of the mRS distribution is significantly different. |
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