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. 2019 Sep 23;34(36):e240.
doi: 10.3346/jkms.2019.34.e240.

In-Hospital and Post-Discharge Recovery after Acute Ischemic Stroke: a Nationwide Multicenter Stroke Registry-base Study

Min Uk Jang  1 , Jihoon Kang  2 , Beom Joon Kim  2 , Jeong Ho Hong  3 , Min Ju Yeo  4 , Moon Ku Han  2 , Byung Chul Lee  1 , Kyung Ho Yu  1 , Mi Sun Oh  1 , Kyung Chan Choi  1 , Sang Hwa Lee  1 , Keun Sik Hong  5 , Yong Jin Cho  5 , Jong Moo Park  6 , Jae Kwan Cha  7 , Dae Hyun Kim  7 , Tai Hwan Park  8 , Kyung Bok Lee  9 , Soo Joo Lee  10 , Jun Lee  11 , Joon Tae Kim  12 , Dong Eog Kim  13 , Jay Chol Choi  14 , Juneyoung Lee  15 , Ji Sung Lee  16 , Philip B Gorelick  17 , Hee Joon Bae  18
Affiliations

In-Hospital and Post-Discharge Recovery after Acute Ischemic Stroke: a Nationwide Multicenter Stroke Registry-base Study

Min Uk Jang et al. J Korean Med Sci. .

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.

Keywords: Brain Infarction: Recovery of Function; Prognosis; Registries; Stroke.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Distribution of mRS scores at discharge and 3 months after stroke onset. Green cells represent the post-discharge recovery group. Orange cells represent the aggravated group. Gray represent the non-changing group. Data are number of patients (%).
mRS = modified Rankin scale.
Fig. 2
Fig. 2. Incidence of in-hospital and post-discharge recovery after acute ischemic stroke.
See this image and copyright information in PMC

Comment in

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