Relationship of functional disability after a recent stroke with recurrent stroke risk
- Authors
- Park, Jong Ho; Ovbiagele, Bruce
- Issue Date
- Feb-2016
- Publisher
- WILEY-BLACKWELL
- Keywords
- Disability; Ischaemic stroke; Modified Rankin Scale; Risk; Vascular outcome
- Citation
- EUROPEAN JOURNAL OF NEUROLOGY, v.23, no.2, pp.361 - 367
- Indexed
- SCIE
SCOPUS
- Journal Title
- EUROPEAN JOURNAL OF NEUROLOGY
- Volume
- 23
- Number
- 2
- Start Page
- 361
- End Page
- 367
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/155110
- DOI
- 10.1111/ene.12837
- ISSN
- 1351-5101
- Abstract
- Background and purpose: Post-stroke disability status is primarily focused on recovery prognostication but the influence of post-stroke disability on future vascular risk is unknown. The relationship between functional disability after an index stroke and risk of recurrent vascular events was examined. Methods: A cohort analysis of 3680 recent non-cardioembolic, non-to-moderate disabled [modified Rankin Scale (mRS) ≤3] stroke patients aged ≥35 years and followed for 2 years was reviewed. The mRS measured at a median of 35 days after the index stroke was analyzed as a dichotomous variable (mRS 3 vs. ≤2) and in a stepwise manner. Independent associations of post-stroke disability by mRS score with ischaemic stroke (primary outcome), stroke/coronary heart disease/vascular death as major vascular events (secondary outcome) and all-cause death (tertiary outcome) were analyzed. Results: Amongst study participants, 435 (11.8%) had an mRS of 3. Compared with mRS ≤2 as no/slight disability, mRS 3 as moderate disability was associated with a higher risk of stroke (adjusted hazard ratio 1.45, 95% confidence interval 1.06-1.99). Compared with mRS 0, there was a progressively higher independent risk for each of the study outcomes: stroke, mRS 1 (1.42, 0.97-2.08), mRS 2 (1.46, 0.97-2.20), mRS 3 (1.89, 1.20-2.97); major vascular events, mRS 1 (1.31, 1.01-1.70), mRS 2 (1.31, 0.99-1.74), mRS 3 (1.46, 1.06-2.01); and all-cause death, mRS 1 (1.75, 1.03-2.98), mRS 2 (2.49, 1.44-4.31), mRS 3 (2.72, 1.43-5.19). Conclusion: Compared with no/slight disability, moderate disability after a recent stroke is linked to a higher risk of recurrent stroke.
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