Association between Heart Failure and Clinical Prognosis in Patients with Acute Ischemic Stroke: A Retrospective Cohort Study

心力衰竭与急性缺血性卒中患者临床预后的关系:一项回顾性队列研究

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Abstract

BACKGROUND AND PURPOSE: Ischemic stroke is a common cause of death worldwide. In clinical practice it is observed that many individuals who have experienced an ischemic stroke also suffer from simultaneous comorbidities such as heart failure, which could be directly associated with a worse clinical prognosis. Therefore, this study analyzed outcomes in terms of the severity of the event, inhospital mortality, duration of hospital stay, and inhospital recurrence of the episode, in order to determine the implications resulting from the presentation of both pathologies. METHODS: This was a retrospective-cohort, hospital-based study. RESULTS: The study included 110 subjects with heart failure (exposed) and 109 subjects without heart failure (nonexposed). The incidence of inhospital mortality was 27.27% in exposed patients and 9.17% in nonexposed patients (p<0.001), and the presence of heart failure increased the risk of death by 92% (p=0.027). According to scores on the National Institutes of Health Stroke Scale, the median severity was worse in exposed than nonexposed patients (16.1 vs. 9.2, p =0.001). The median hospital stay was 9 days in subjects with heart failure and 7 days in nonexposed patients (p=0.011). The rate of inhospital stroke did not differ significantly between exposed and nonexposed patients (1.82% vs. 0.92%, p=0.566). CONCLUSIONS: Individuals with heart failure who suffer from an acute ischemic stroke show worse clinical outcomes in terms of mortality, event severity, and duration of hospital stay.

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