Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry
| Autor: | Monika Martinek-Bregel, Jörg Slany, Marion Avanzini, Angelika Pratter, Claudia Stöllberger, Andreas Valentin, Christina Steger |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Heart disease chemistry.chemical_compound Internal medicine Atrial Fibrillation Humans Medicine Hospital Mortality Prospective Studies Registries Prospective cohort study Stroke Aged Aged 80 and over Creatinine business.industry Vascular disease Atrial fibrillation Odds ratio Prognosis medicine.disease Surgery Hospitalization chemistry Austria Multivariate Analysis Female Nervous System Diseases Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | European Heart Journal. 25:1734-1740 |
| ISSN: | 0195-668X |
| Popis: | Stroke patients with atrial fibrillation (AF) have a poorer neurological outcome than stroke patients without AF. Whether stroke patients with AF also have a higher rate of medical complications is unknown. The aim of the study was to compare the in-hospital course of acute stroke patients with and without AF.The Austrian Stroke registry was a prospective multi-centre study involving 57 medical departments documenting the hospital course of consecutive stroke patients from June 1999 to October 2000. AF was diagnosed in 304 (31%) of 992 patients. Patients with AF were older (79 versus 75 years, p0.0004) than no-AF patients. There were more cases of pneumonia (23% versus 9%, p0.0004), pulmonary oedema (12% versus 6%, p0.0004) and symptomatic intracerebral haemorrhage (8% versus 2%, p0.0004) in AF compared to no-AF. In-hospital mortality was higher in AF (25% versus 14%, p0.0004), and neurological outcome was poorer (65 versus 90 Barthel index, p0.0004). On multivariable logistic regression analysis, however, AF was no predictor for mortality, but a Barthel index of zero (odds ratio 5.30, 95% CI 3.10-9.08, p0.0001), a National Institutes of Health Stroke Scale21 or comatose (odds ratio 3.13, 95% CI 2.26-4.32, p0.0001), age75 years (odds ratio 3.15, 95% CI 1.85-5.37, p0.0001), heart rate100 min(-1) (odds ratio 2.15, 95% CI 1.26-3.66, p = 0.0049), obstructive pulmonary disease (odds ratio 2.58, 95% CI 1.03-6.48, p = 0.0442) and creatinine125 micromol/l (odds ratio 1.84, 95% CI 1.00-3.37, p = 0.0479).Stroke in AF is associated with a poor prognosis, an increased rate of medical and neurological complications and a higher in-hospital mortality than in no-AF. |
| Databáze: | OpenAIRE |
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