Dataset Information

Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study.

ABSTRACT:

Background and purpose

Few studies have investigated the relationship between the specific functional factors potentially associated with functional level and stroke recurrence. We conducted a study of patients with noncardioembolic ischemic stroke (NCIS) to determine the functional factors affecting recurrence within the first year.

Methods

In total, 568 first-ever NCIS patients (age=65.1±17.4 years, mean±SD) were analyzed in a multicenter, prospective cohort study registered from August 2012. Demographic characteristics, past medical history, comorbidities, laboratory data, stroke features in neuroimaging, acute treatments, and medications at discharge were assessed. Functional factors reflecting gross functional impairment, ambulatory function, motor function, activities of daily living, cognition, language ability, swallowing function, mood, and quality of life were comprehensively evaluated in face-to-face assessments using standardized tools at the time of discharge.

Results

The cumulative incidence of stroke recurrence in NCIS was 6.0% (n=34) at 1 year. The period from admission to discharge was 34.4±7.0 days. The independent predictors of stroke recurrence within 1 year in multivariate Cox proportional-hazards regression analyses were 1) age [per-year hazard ratio (HR)=1.04, 95% confidence interval (CI)=0.97-1.06, p=0.048], 2) Charlson Comorbidity Index higher than 2 (HR=1.72, 95% CI=1.26-2.22, p=0.016), 3) modified Rankin Scale score of 3 or more at discharge (HR=1.56, 95% CI=1.22-1.94, p=0.032), and 4) Functional Ambulation Category of 3 or less at discharge (HR=2.56, 95% CI=1.84-3.31, p=0.008).

Conclusions

In addition to patient age, moderate-to-severe functional impairment requiring the help of others (especially for ambulation) at the time of discharge and the severity of comorbidity were independent predictors of stroke recurrence within 1 year of the first NCIS.

SUBMITTER: Kim MS

PROVIDER: S-EPMC6325355 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study.

Kim Min Su MS Joo Min Cheol MC Sohn Min Kyun MK Lee Jongmin J Kim Deog Young DY Lee Sam Gyu SG Shin Yong Il YI Kim Soo Yeon SY Oh Gyung Jae GJ Lee Yang Soo YS Han Eun Young EY Han Junhee J Ahn Jeonghoon J Chang Won Hyuk WH Kim Yun Hee YH

Journal of clinical neurology (Seoul, Korea) 20190101 1

<h4>Background and purpose</h4>Few studies have investigated the relationship between the specific functional factors potentially associated with functional level and stroke recurrence. We conducted a study of patients with noncardioembolic ischemic stroke (NCIS) to determine the functional factors affecting recurrence within the first year.<h4>Methods</h4>In total, 568 first-ever NCIS patients (age=65.1±17.4 years, mean±SD) were analyzed in a multicenter, prospective cohort study registered fro ...[more]

PMID: 30618217

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Project description:PurposeTo investigate radiomics based on DWI (diffusion-weighted imaging) for predicting 1-year ischemic stroke recurrence.MethodsA total of 1,580 ischemic stroke patients were enrolled in this retrospective study conducted from January 2018 to April 2021. Demographic and clinical characteristics were compared between recurrence and non-recurrence groups. On DWI, lesions were segmented using a 2D U-Net automatic segmentation network. Further, radiomics feature extraction was done using the segmented mask matrix on DWI and the corresponding ADC map. Additionally, radiomics features were extracted. The study participants were divided into a training cohort (n = 157, 57 recurrence patients, and 100 non-recurrence patients) and a test cohort (n = 846, 28 recurrence patients, 818 non-recurrence patients). A sparse representation feature selection model was performed to select features. Further classification was accomplished using a recurrent neural network (RNN). The area under the receiver operating characteristic curve values was obtained for model performance.ResultsA total of 1,003 ischemic stroke patients (682 men and 321 women; mean age: 65.90 ± 12.44 years) were included in the final analysis. About 85 patients (8.5%) recurred in 1 year, and patients in the recurrence group were older than the non-recurrence group (P = 0.003). The stroke subtype was significantly different between recurrence and non-recurrence groups, and cardioembolic stroke (11.3%) and large artery atherosclerosis patients (10.3%) showed a higher recurrence percentage (P = 0.005). Secondary prevention after discharge (statins, antiplatelets, and anticoagulants) was found significantly different between the two groups (P = 0.004). The area under the curve (AUC) of clinical-based model and radiomics-based model were 0.675 (95% CI: 0.643-0.707) and 0.779 (95% CI: 0.750-0.807), respectively. With an AUC of 0.847 (95% CI: 0.821-0.870), the model that combined clinical and radiomic characteristics performed better.ConclusionDWI-based radiomics could help to predict 1-year ischemic stroke recurrence.

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Dataset Information

Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study.

Background and purpose

Methods

Results

Conclusions

Publications

Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study.

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