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Stroke severity, early recovery and outcome are each related with clinical classification of stroke : Data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST)

Sprigg, N. (författare)
Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom
Gray, L.J. (författare)
Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom
Bath, P.M.W. (författare)
Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom
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Lindenstrom, E. (författare)
Lindenstrøm, E., Leo Pharma A/S, Ballerup, Denmark
Boysen, G. (författare)
Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark
De, Deyn P.P. (författare)
De Deyn, P.P., Department of Neurology, A. Z. Middelheim, ZNA, Antwerpen, Belgium
Friis, P. (författare)
Vest-Agder Sentralsykehus, Kristiansand, Norway
Leys, D. (författare)
Clinique Neurologique, CHRU de Lille, Lille, France
Marttila, R. (författare)
Department of Neurology, Turku University Central Hospital, Turku, Finland
Olsson, Jan-Edvin (författare)
Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Neurologi,Neurologiska kliniken
O'Neill, D. (författare)
Department of Age Related Health Care, Adelaide and Meath Hospital, Dublin, Ireland
Ringelstein, E.B. (författare)
Klinik für Neurologie, Universität Münster, Münster, Germany
van, der Sande J.-J. (författare)
van der Sande, J.-J., Slotervaartziekenhuis, Amsterdam, Netherlands
Turpie, A.G.G. (författare)
Hamilton General Hospital, Hamilton, Canada
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Institute of Neuroscience, University of Nottingham, Nottingham, United Kingdom Lindenstrøm, E, Leo Pharma A/S, Ballerup, Denmark (creator_code:org_t)
Elsevier BV, 2007
2007
Engelska.
Ingår i: Journal of the Neurological Sciences. - : Elsevier BV. - 0022-510X .- 1878-5883. ; 254:1-2, s. 54-59
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Introduction: Baseline severity and clinical stroke syndrome (Oxford Community Stroke Project, OCSP) classification are predictors of outcome in stroke. We used data from the 'Tinzaparin in Acute Ischaemic Stroke Trial' (TAIST) to assess the relationship between stroke severity, early recovery, outcome and OCSP syndrome. Methods: TAIST was a randomised controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1484 patients with acute ischaemic stroke. Severity was measured as the Scandinavian Neurological Stroke Scale (SNSS) at baseline and days 4, 7 and 10, and baseline OCSP clinical classification recorded: total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarction (POCI). Recovery was calculated as change in SNSS from baseline at day 4 and 10. The relationship between stroke syndrome and SNSS at days 4 and 10, and outcome (modified Rankin Scale at 90 days) were assessed. Results: Stroke severity was significantly different between TACI (most severe) and LACI (mildest) at all four time points (p < 0.001), with no difference between PACI and POCI. The largest change in SNSS score occurred between baseline and day 4, improvement was least in TACI (median 2 units), compared to other groups (median 3 units) (p < 0.001). If SNSS did not improve by day 4, then early recovery and late functional outcome tended to be limited irrespective of clinical syndrome (SNSS, baseline: 31, day 10: 32, mRS, day 90: 4), patients who recovered early tended to continue to improve and had better functional outcome irrespective of syndrome (SNSS, baseline: 35, day 10: 50, mRS, day 90: 2). Conclusions: Although functional outcome is related to baseline clinical syndrome (best with LACI, worst with TACI), patients who improve early have a more favourable functional outcome, irrespective of their OCSP syndrome. Hence, patients with a TACI syndrome may still achieve a reasonable outcome if early recovery occurs. © 2007 Elsevier B.V. All rights reserved.

Nyckelord

Acute stroke
Clinical classification
Functional outcome
Ischaemic stroke
Recovery
MEDICINE
MEDICIN

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