Clinical Characteristics And Functional Outcome Of Wake-up Stroke

Objective : To investigate the clinical characteristics and early outcomes of wake-up stroke(WUS).Methods:Between April and September 2017,274 consecutive patiens with acute ischemic stroke admitted to the Department of Neurology,the First Affiliated Hospital of Chongqing Medical University within 3 days of onset were enrolled prospectively.They were randomly divided into either a wake up stroke group or a non wake up stroke group according to whether the onset time was clear.The modified Rankin Scale(mRS)score at 90 d were followed up.The patients with wake-up stroke were also divided into either a favorable prognosis group(mRS score 0-1)or a unfavorable prognosis group(mRS score ≥ 2).The clinical features,prognosis,and factors affecting early prognosis of wake-up stroke were analyzed.Demographic information,baseline clinical data,imaging characteristics,National Institutes of Health Stroke Scale(NIHSS)score,Glasgow Coma Scale(GCS)score,TOAST(Trial of Org 10172 in Acute Stroke Treatment criteria)classification of all patients were collected.Univariate analysis was used to compare each factor difference between the wake-up stroke group and the non-wake-up stroke group,as well asbetween the favorable prognosis group and the unfavorable prognosis group.Multivariate logistic regression equation was used to analyze the independent risk factors for early unfavorable prognosis of wake-up stroke.Results:In 274 patients with acute ischemic stroke,70(25.5%)were wake-up strokes,of them,47 had favorable prognosis,and 23 had poor prognosis.Univariate analysis showed that there were no significant differences in risk factors,severity of disease,TOAST etiological types,and prognosis at 90 d in patients with wake-up stroke and non-wake-up stroke(all P > 0.05).The serum albumin level of the wake-up stroke group was significantly higher than that of the non-wake-up stroke group(P < 0.05).There were significant differences in NIHSS scores on admission,NIHSS ≥5 scores on admission,and GCS scores on admission between the favorable prognosis group and the unfavorable prognosis group(all P < 0.05).Multivariate logistic regression analysis showed that NIHSS score ≥5on admission(OR,1.042,95% Cl 1.770-28.013,P <0.05)was the independent risk factor for unfavorable prognosis of wake-up stroke.Conclusions:Wake-up stroke and non-wake-up stroke had similar risk factors,severity of disease,TOAST stroke etiology classification,and early prognosis.NIHSS ≥5 scores on admission was the independent risk factor for early unfavorable prognosis of wake-up stroke.