The association of post-stroke neurological improvement with risk of subsequent deterioration due to stroke events

S. Aslanyan*, C. J. Weir, C. S. Johnston, M. Krams, A. P. Grieve, K. R. Lees

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We sought to simultaneously confirm that substantial recovery at day 1 and day 7 after acute ischaemic stroke onset is associated with subsequent neurological deterioration in patients of the Acute Stroke Therapy by Inhibition of Neutrophils randomized clinical trial. Substantial recovery was assessed by improvement in the National Institutes of Health Stroke Score (NIHSS). Neurological deterioration was defined as any stroke event or NIHSS worsening from recovery assessment to day 90. After adjusting for age, t-PA and day 1 NIHSS, there was a non-significant tendency of substantial (pre-specified as 75%) recovery at day 1 to be associated with later deterioration [odds ratio (OR) 2.47; 95% CI, 0.95-6.50]. The corresponding OR for substantial (pre-defined as 65%) recovery at day 7 was 1.84 (0.85-3.96). Other thresholds for recovery were significantly associated with later deterioration: > 50%, 80%, 90% and 100% for day 1 and > 50%, 60%, 70%, 90% and 100% for day 7. The effect of recovery at day 1 was more important than that of later recovery. This study confirms the association between recovery and subsequent neurological deterioration and is the first to indicate the greater importance of acute recovery at day 1 in comparison with later recovery.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalEuropean Journal of Neurology
Volume14
Issue number1
DOIs
Publication statusPublished - Jan 2007

Keywords

  • deterioration
  • ischaemic stroke
  • recovery
  • transient ischemic attack
  • ACUTE ISCHEMIC-STROKE
  • RANDOMIZED CONTROLLED-TRIAL
  • SHORT-TERM PROGNOSIS
  • CEREBRAL-ISCHEMIA

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