Study Of Predictors For Poor Outcomes In Patients With TIA Or Minor Stroke

Objectives As nondisabling cerebrovascular events, transient ischemic attack(TIA) and minor stroke are associated with a high risk of early recurrent stroke. In this study, we aimed to identify which factors are associated with the short-term poor outcomes in patients with TIA and minor stroke by analyzing the relative data in the China National Stroke Registry(CNSR).Methods The China National Stroke Registry prospectively and consecutively recruited patients with TIA and minor stroke from 132 hospitals between September 2007 and August 2008. Baseline information including patient demographics, vascular risk factors, clinical characteristics were collected. Evaluation indicators of outcome include 90-day stroke recurrence, poor functional outcome(m RS=2-6) and all-cause death. Multivariate logistic model was used to determine the association between risk factors and short-term poor outcomes in patients with TIA and minor stroke.Results Of 981 patients with TIA and 4669 patients with minor stroke during 90-day follow-up, 505(8.9%) patients experienced recurrent stroke, 1263(22.4%) had poor functional outcome and 185(3.3%) died. After adjusting relative risk factors which conformed in univariate analysis respectively, multivariate logistic model identified that hypertension(OR 1.329, 95% CI, 1.061-1.664), atrial fibrillation(OR 2.004, 95% CI, 1.456-2.758), coronary heart disease(OR 1.535, 95% CI, 1.202-1.960), neurological deterioration(OR 2.062, 95% CI, 1.375-3.092) and discharge diagnosis for minor stroke(OR 2.053, 95% CI, 1.500-2.809) were the independent predictors for 90-day recurrent stroke. Age(OR 1.041, 95% CI, 1.034-1.047), diabetes mellitus(OR 1.353, 95% CI, 1.165-1.572), atrial fibrillation(OR 1.316, 95% CI, 1.010-1.716), time from onset to admission within 24 hours(OR 1.179, 95% CI, 1.031-1.349), neurological deterioration(OR 5.808, 95% CI, 4.167-8.095) and discharge diagnosis for minor stroke(OR 4.054, 95% CI, 3.075-5.345) were independently associated with 90-day poor functional outcome. The independent predictors for the death were age(OR 1.027, 95% CI, 1.013-1.041), atrial fibrillation(OR 2.139, 95% CI, 1.362-3.360), coronary heart disease(OR 1.709, 95% CI, 1.184-2.466) and neurological deterioration(OR 3.523, 95% CI, 2.114-5.871).Conclusions The short-term risk of poor clinical outcome in Chinese patients with a minor stroke was substantial. Therefore, patients with a minor stroke should be given expeditious assessment and urgent aggressive intervention.