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Abstract Details

In-Hospital Stroke: Risk Factors and Outcomes amongst Active Cancer Patients
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)

Patients with in-hospital stroke have worse outcomes compared to those presenting from the community. However, most data are derived from patients with perioperative stroke. There remains a scarcity of literature examining in-hospital stroke in the context of active cancer despite a growing prevalence of cancer survivors who are at increased risk of stroke, and stroke-related morbidity and mortality.

To characterize risk factors and outcomes amongst active cancer patients who experience in-hospital stroke.

A retrospective review was conducted in patients evaluated through the in-hospital stroke alert protocol in a university hospital to identify those with in-hospital stroke from 2016 to 2018. Charts were analyzed for patient demographics, medical history, presenting neurologic examination, laboratories, interventions, final diagnosis, and discharge disposition.

Of 969 in-hospital stroke activations included, 13% had a final diagnosis of stroke (n=122), of which 20% (n=24) of patients had active cancer. Relative to all other in-hospital strokes (n=98), patients with active cancer had a greater proportion of heart failure (39% vs 8%, p=0.004) and lower platelet counts (144 x 109/L vs 210 x 109/L, p=0.036). Hemorrhagic stroke was slightly more common in patients with active cancer (50% vs 29%, p=0.055). Discharge outcomes did not differ with respect to a diagnosis of active cancer.

Approximately 20% of patients with in-hospital stroke had active cancer, with a higher prevalence of heart failure and thrombocytopenia, and hemorrhagic stroke. However, despite a diagnosis active cancer, clinical outcomes did not differ between the groups. Given continued advances in cancer therapies, it is critical to further investigate how to improve diagnosis and treatment of stroke in this unique population.

Adriana Naomi Sari, MD (McGaw Medical Center at Northwestern University)
Dr. Sari has nothing to disclose.
Nathan Muntz No disclosure on file
Zachary Benjamin Bulwa, MD (University of Chicago) Dr. Bulwa has nothing to disclose.
Shyam Prabhakaran, MD (University of Chicago) The institution of Dr. Prabhakaran has received research support from NIH . The institution of Dr. Prabhakaran has received research support from AHRQ. Dr. Prabhakaran has received publishing royalties from a publication relating to health care.