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In-Hospital and Post-Discharge Recovery After Acute Ischemic Stroke: A Nationwide Multicenter Stroke Registry-base Study

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Author(s)
Min Uk JangJihoon KangBeom Joon KimJeong-Ho HongMin Ju YeoMoon-Ku HanByung-Chul LeeKyung-Ho YuMi-Sun OhKyung-Chan ChoiSang-Hwa LeeKeun-Sik HongYong-Jin ChoJong-Moo ParkJae Kwan ChaDae-Hyun KimTai Hwan ParkKyung Bok LeeSoo Joo LeeJun LeeJoon-Tae KimDong-Eog KimJay Chol ChoiJuneyoung LeeJi Sung LeePhilip B. GorelickHee-Joon Bae
Keimyung Author(s)
Hong, Jeong Ho
Department
Dept. of Neurology (신경과학)
Journal Title
Journal of Korean medical science
Issued Date
2019
Volume
34
Issue
36
Keyword
RegistriesStrokeBrain Infarction: Recovery of FunctionPrognosis
Abstract
Background:
Using data from a large national stroke registry, we aimed to investigate the incidence and determinants of in-hospital and post-discharge recovery after acute ischemic stroke and the independence of their occurrence.

Methods:
In-hospital recovery was defined as an improvement of 4 points or > 40% in the National Institutes of Health Stroke Scale (NIHSS) score from admission to discharge. Post-discharge recovery was defined as any improvement in the modified Rankin Scale (mRS) score from discharge to 3 months after stroke onset. Two analytic methods (multivariate and multivariable logistic regression) were applied to compare the effects of 18 known determinants of 3-month outcome and to verify whether in-hospital and post-discharge recovery occur independently.

Results:
During 54 months, 11,088 patients with acute ischemic stroke meeting the eligibility criteria were identified. In-hospital and post-discharge recovery occurred in 36% and 33% of patients, respectively. Multivariate logistic regression with an equality test for odds ratios showed that 7 determinants (age, onset-to-admission time, NIHSS score at admission, blood glucose at admission, systolic blood pressure, smoking, recanalization therapy) had a differential effect on in-hospital and post-discharge recovery in the way of the opposite direction or of the same direction with different degree (all P values < 0.05). Both in-hospital and post-discharge recovery occurred in 12% of the study population and neither of them in 43%. The incidence of post-discharge recovery in those with in-hospital recovery was similar to that in those without (33.8% vs. 32.7%, respectively), but multivariable analysis showed that these 2 types of recovery occurred independently.

Conclusion:
Our findings suggest that, in patients with acute ischemic stroke, in-hospital and post-discharge recovery may occur independently and largely in response to different factors.
Keimyung Author(s)(Kor)
홍정호
Publisher
School of Medicine (의과대학)
Citation
Min Uk Jang et al. (2019). In-Hospital and Post-Discharge Recovery After Acute Ischemic Stroke: A Nationwide Multicenter Stroke Registry-base Study. Journal of Korean medical science, 34(36), e240–e240. doi: 10.3346/jkms.2019.34.e240
Type
Article
ISSN
1598-6357
Source
https://jkms.org/DOIx.php?id=10.3346/jkms.2019.34.e240
DOI
10.3346/jkms.2019.34.e240
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42371
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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