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. 2015 Sep 8:15:164.
doi: 10.1186/s12883-015-0414-1.

Impact of chronic inflammatory airway disease on stroke severity and long-term survival after ischemic stroke--a retrospective analysis

Karl Georg Haeusler  1   2 , Juliane Herm  3 , Maria Konieczny  4 , Ulrike Grittner  5   6 , Mitja Lainscak  7 , Matthias Endres  8   9   10   11   12 , Wolfram Doehner  13   14   15
Affiliations

Impact of chronic inflammatory airway disease on stroke severity and long-term survival after ischemic stroke--a retrospective analysis

Karl Georg Haeusler et al. BMC Neurol. .

Abstract

Background: Chronic inflammatory airway disease (CIAD) has emerged as independent risk factor for cardiovascular mortality and ischemic stroke but the impact of co-existing CIAD in patients with ischemic stroke is less clear.

Methods: We retrospectively analyzed 1013 patients with acute ischemic stroke who were consecutively admitted to the Department of Neurology, Charité - Universitätsmedizin Berlin, Germany within one year. Mean follow-up was 80 months (IQR 32-85 months). Using multivariable regression models we analyzed the impact of CIAD (defined as chronic obstructive pulmonary disease or asthma bronchiale) on stroke severity and outcome.

Results: Co-existing CIAD was evident in 7.1 % (n = 72) of all patients with acute ischemic stroke. Baseline characteristics of stroke patients with CIAD did not differ significantly from ischemic stroke patients without CIAD. Age (OR 1.17 [95 % CI 1.03-1.37] per decade), atrial fibrillation (OR 3.43 [95 % CI 2.47-4.78]) and coronary artery disease (OR 1.51 [95 % CI 1.07-2.14]) but not a history of CIAD (p = 0.30) were associated with severe stroke (NIHSS≥11) on hospital admission. Age (HR 1.70 [95 % CI 1.53-1.87] per decade), peripheral artery disease (HR 1.91 [95 % CI 1.35-2.7]), stroke severity at hospital admission (NIHSS per point HR 1.08 [95 % CI 1.06-1.10]), and history of CIAD (HR 1.43 [95 % CI 1.02-2.00]) were independently associated with mortality during long-term follow-up. However, CIAD was not significantly associated with short-term mortality after stroke.

Conclusion: Co-existing CIAD showed no significant association with stroke severity at hospital admission and early mortality after ischemic stroke. CIAD was negatively associated with long-term survival after ischemic stroke.

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Figures

Fig. 1
Fig. 1
Kaplan-Meier estimates of cumulative survival after ischemic stroke by co-existing CIAD. Kaplan-Meier estimates of cumulative survival after ischemic stroke stratified by co-existing chronic inflammatory airway disease (CIAD) in a 892 patients with ischemic stroke (p = 0.009); b 892 patients with ischemic stroke and 179 patients with TIA (p = 0.036); c 179 patients with TIA (p = 0.469)
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