Progression in acute ischemic stroke: frequency, risk factors and prognosis

Background and purpose: The aim of this study was to investigate the frequency, possible predictive factors and the prognosis of deteriorating ischemic stroke. Methods: A total of 266 stroke patients who presented within 24 h of onset were enrolled. Clinical deterioration was defined as a decrease of 1 points in the Canadian Neurological Scale (CNS). Rankin Score (RS) was performed at discharge and at six months. Results: Of the 266 patients studied, 26 (9.8%) worsened. Involvement of posterior circulation (odds ratio (OR) 3.16) and noncardioembolic infarction (OR 4.5) were found to be independently associated with neurological worsening. Death occurred in 19.2% of progressive (P) and in 4.16% of nonprogressive (NP) groups. Functional outcome was worse in the P than in NP patients at discharge and at sixth months. Conclusions: Involvement of posterior circulation and noncardioembolic subtypes of infarct independently affect neurological progression in acute ischemic stroke. Clinical deterioration significantly worsens the prognosis. (C) 2003 Elsevier Science Ltd. All rights reserved.