In-hospital and post-discharge recovery after acute ischemic stroke: A nationwide multicenter stroke registry-base study

Min Uk Jang, Jihoon Kang, Beom Joon Kim, Jeong Ho Hong, Min Ju Yeo, Moon Ku Han, Byung Chul Lee, Kyung Ho Yu, Mi Sun Oh, Kyung Chan Choi, Sang Hwa Lee, Keun Sik Hong, Yong Jin Cho, Jong Moo Park, Jae Kwan Cha, Dae Hyun Kim, Tai Hwan Park, Kyung Bok Lee, Soo Joo Lee, Jun LeeJoon Tae Kim, Dong Eog Kim, Jay Chol Choi, Juneyoung Lee, Ji Sung Lee, Philip B. Gorelick, Hee Joon Bae

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Article numbere240
JournalJournal of Korean medical science
Volume34
Issue number36
DOIs
Publication statusPublished - 2019

Keywords

  • Brain Infarction
  • Prognosis
  • Recovery of Function
  • Registries
  • Stroke

ASJC Scopus subject areas

  • Medicine(all)

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    Jang, M. U., Kang, J., Kim, B. J., Hong, J. H., Yeo, M. J., Han, M. K., Lee, B. C., Yu, K. H., Oh, M. S., Choi, K. C., Lee, S. H., Hong, K. S., Cho, Y. J., Park, J. M., Cha, J. K., Kim, D. H., Park, T. H., Lee, K. B., Lee, S. J., ... Bae, H. J. (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]. https://doi.org/10.3346/jkms.2019.34.e240