MedWire News: Recovery patterns differ following ischemic and hemorrhagic stroke, whereas prognostic indicators are similar, an analysis of the ChinaQUEST database suggests.
ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) is a multicenter, prospective, 62-hospital registry study of the quality of stroke management in China. The present analysis included data on 6354 patients who were assessed at baseline, and at 3 and 12 months poststroke.
In all, 4782 patients had suffered an ischemic stroke (IS) and 1572 an intracerebral hemorrhage (ICH)
The study, which is reported in the journal Stroke, found that both stroke severity and the rate of functional recovery in the first 3 months were significantly greater for patients with ICH than those with IS.
One year after a stroke, patients with IS were twice as likely to experience a good outcome (defined as a modified Rankin Scale score <3) than those with ICH.
In multivariate analysis, factors significantly associated with a poor outcome at 12 months following IS were diabetes and atrial fibrillation whereas use of antiplatelet agents and lipid-lowering therapy were associated with a good outcome.
Following ICH, low education and atrial fibrillation were associated with a poor outcome whereas use of antihypertensive therapy was associated with a good outcome.
In their discussion, Jade Wei (The George Institute for International Health, Sydney, Australia) and co-authors express surprise that the presence of hypertension did not predict a poor outcome in either IS or ICH patients.
Similarly, the association between lipid-lowering therapy and a good outcome was contrary to their expectations. They suggest that the result "may reflect improved quality of care for those who already have high cardiovascular risk and/or for the wealthy who can afford expensive blood tests necessary to diagnose hyperlipidemia."
The researchers conclude: "Patients with intracerebral hemorrhage and ischemic stroke have different recovery patterns in China."
However, the team adds, the stroke types share similar prognostic factors and evidence-based secondary prevention therapies that maximize chances of a good outcome.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
Free abstract
