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Abstract Details

Recovered Neurological Worsening in Hospitalized Patients with Acute Ischemic Stroke
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)
Neurological worsening (NW) occurs often in hospitalized patients with acute stroke and relates with unfavorable outcome.
We aimed to characterize clinical features and outcome of patients with recovered neurological worsening (RNW) at discharge.

In consecutive patients admitted to a single hospital within 7 days after acute ischemic stroke (AIS) between January 2012 and December 2018, NW was prospectively captured during hospitalization if patients have an increase of National Institutes of Health Stroke Scale (NIHSS) score ≥2 (total) or ≥1 (motor or consciousness) or any new neurological symptom. RNW was defined as NIHSS score at discharge was the same as or lower than the score at admission. Clinical features and modified Rankin Scale (mRS) score at 3 months were compared between patients with and without RNW. 

Of 1862 patients, 163 patients (8.8%) experienced NW. Among patients with NW, 91 (55.8%) showed RNW. Mean hospital days were 10.5 and 10.3 in patients with and without RNW, respectively. Patients with RNW had higher initial median (IQR) NIHSS score [5 (3-9) vs. 4 (2-6), p=0.006], but lower discharge NIHSS score [4 (2-7) vs. 6 (5-10), p<0.001) than those without. An increase of NIHSS score at NW was less, while mean onset to NW day tended to be shorter in patients with RNW (2.04 vs. 3.04, p=0.052) than those without. There were no significant differences in demographic and risk factor profiles. Proportions of good outcome defined as 0-2 of mRS score were 39% and 15% in patients with and without RNW, respectively. Cardioembolic stroke and stroke recurrence as an underlying etiology of NW tended to be more common in patients with RNW.

About half of AIS patients with NW were found to have recovered on discharge. Further research is needed to find effective strategies to prevent and treat NW during acute stroke care.


No disclosure on file
Tai Hwan Park, MD No disclosure on file
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