Predictors of outcome in acute ischemic cerebrovascular syndromes: The GIFA study

Abstract

Background: Today it may be more useful to use the term acute ischemic cerebrovascular syndrome (AICS) to define a spectrum of disease ranging from TIA to stroke and that share a similar underlying pathophysiology: cerebral ischemia. The aim of this study is to evaluate the prognostic importance of some demographic, laboratory and clinical variables on the outcome in hospitalized patients with a discharge diagnosis suggestive of acute ischemic cerebral syndrome (AICS).

Methods: 17,377 Subjects were enrolled in the GIFA study, a multicenter survey of hospitalized older patients. 1878 Subjects with a main discharge diagnosis suggestive of acute ischemic cerebrovascular syndrome (AICS) represent the final sample. The primary outcomes of this study were: (1) in-hospital mortality; (2) cognitive impairment at discharge; (3) functional status at discharge.

Results: Age, WBC count, glucose blood level at admission and Charlson index score were directly associated with in-hospital mortality. Age, WBC count, Charlson index score and disability at admission are directly associated with cognitive impairment at discharge. Finally, age, Charlson index score and disability at admission are directly associated with disability at discharge.

Conclusions: Our study evaluated prognosis in the light of the three main aspects of mortality, disability and cognitive impairment that showed substantial sharing for most of the prognostic factors, probably owing to the possible strict association of these outcome indicators with markers of ischemic brain damage extent (WBC) and/or individual response to an ischemic event by neuroplasticity (age, comorbidity) in subjects with AICS.