Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke
Acute ischemic stroke outcomes depend on various factors. We investigated whether the outcome-relevant factor (ORF) profiles differ between different vascular territories and different therapeutic strategies. In this retrospective study, we analyzed 410 comprehensive stroke center patients [median a...
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2025-04-01
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| author | Manuel Bolognese Mareike Österreich Martin Müller Alexander von Hessling Grzegorz Marek Karwacki Lehel-Barna Lakatos |
| author_facet | Manuel Bolognese Mareike Österreich Martin Müller Alexander von Hessling Grzegorz Marek Karwacki Lehel-Barna Lakatos |
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| description | Acute ischemic stroke outcomes depend on various factors. We investigated whether the outcome-relevant factor (ORF) profiles differ between different vascular territories and different therapeutic strategies. In this retrospective study, we analyzed 410 comprehensive stroke center patients [median age of 70 years (IQR 57–80), 125 women (30%)] by analyzing five groups: all patients, patients with infratentorial infarctions only (n = 80), all patients with supratentorial infarctions (n = 330), patients with supratentorial infarctions without (n = 269), and with mechanical thrombectomy (n = 61). Outcomes were classified with the modified Rankin scale as ≤2 (good) or >2 (poor) after three months. The patient group with infratentorial strokes was compared to the group of patients with supratentorial strokes using the Kruskal–Wallis test or chi-squared statistics. Within each of the five stroke groups, univariate logistic regression analysis was used to identify the ORF of a poor outcome; if more than one ORF was identified, all identified factors were included in one multinomial logistic regression analysis model. Compared to the patients with supratentorial strokes, the patients with infratentorial stroke exhibited a less severe neurological deficit at entry and lower rates of ischemic heart disease, thrombolytic intervention, and cardio-embolism but a higher rate of large vessel disease. After multinomial logistic regression analysis, a poor outcome in the infratentorial group was associated with atrial fibrillation [odds ratio (OR) 13.73 (95% confidence interval 1.05–181.89), <i>p</i> = 0.04], estimated glomerular filtration rate [OR 0.96 (0.91–0.99)], <i>p</i> = 0.02], and marginally with diabetes mellitus [OR 7.69 (0.96–62.63), <i>p</i> = 0.05]. In all three supratentorial stroke groups, the neurological deficit as scored by the National Institute of Health Stroke Scale [OR 1.32 (1.22–1.44), <i>p</i> < 0.0001] was predominantly associated with a poor outcome, accompanied by age only in the group of all supratentorial strokes [OR 1.04 (1.01–1.08), <i>p</i> = 0.01]. In this cohort of mild to moderate stroke patients, the ORFs differed between the supra- and infratentorial stroke populations. |
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| spelling | doaj-art-41fa65a8e2ea4102b8e27c1750f18b0d2025-08-20T02:18:14ZengMDPI AGLife2075-17292025-04-0115463310.3390/life15040633Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic StrokeManuel Bolognese0Mareike Österreich1Martin Müller2Alexander von Hessling3Grzegorz Marek Karwacki4Lehel-Barna Lakatos5Department of Neurology and Neurorehabilitation, Lucerne Cantonal Hospital, 6000 Lucerne, SwitzerlandDepartment of Neurology and Neurorehabilitation, Lucerne Cantonal Hospital, 6000 Lucerne, SwitzerlandDepartment of Neurology and Neurorehabilitation, Lucerne Cantonal Hospital, 6000 Lucerne, SwitzerlandDepartment of Radiology, Section Neuroradiology, Lucerne Cantonal Hospital, 6000 Lucerne, SwitzerlandDepartment of Radiology, Section Neuroradiology, Lucerne Cantonal Hospital, 6000 Lucerne, SwitzerlandDepartment of Neurology and Neurorehabilitation, Lucerne Cantonal Hospital, 6000 Lucerne, SwitzerlandAcute ischemic stroke outcomes depend on various factors. We investigated whether the outcome-relevant factor (ORF) profiles differ between different vascular territories and different therapeutic strategies. In this retrospective study, we analyzed 410 comprehensive stroke center patients [median age of 70 years (IQR 57–80), 125 women (30%)] by analyzing five groups: all patients, patients with infratentorial infarctions only (n = 80), all patients with supratentorial infarctions (n = 330), patients with supratentorial infarctions without (n = 269), and with mechanical thrombectomy (n = 61). Outcomes were classified with the modified Rankin scale as ≤2 (good) or >2 (poor) after three months. The patient group with infratentorial strokes was compared to the group of patients with supratentorial strokes using the Kruskal–Wallis test or chi-squared statistics. Within each of the five stroke groups, univariate logistic regression analysis was used to identify the ORF of a poor outcome; if more than one ORF was identified, all identified factors were included in one multinomial logistic regression analysis model. Compared to the patients with supratentorial strokes, the patients with infratentorial stroke exhibited a less severe neurological deficit at entry and lower rates of ischemic heart disease, thrombolytic intervention, and cardio-embolism but a higher rate of large vessel disease. After multinomial logistic regression analysis, a poor outcome in the infratentorial group was associated with atrial fibrillation [odds ratio (OR) 13.73 (95% confidence interval 1.05–181.89), <i>p</i> = 0.04], estimated glomerular filtration rate [OR 0.96 (0.91–0.99)], <i>p</i> = 0.02], and marginally with diabetes mellitus [OR 7.69 (0.96–62.63), <i>p</i> = 0.05]. In all three supratentorial stroke groups, the neurological deficit as scored by the National Institute of Health Stroke Scale [OR 1.32 (1.22–1.44), <i>p</i> < 0.0001] was predominantly associated with a poor outcome, accompanied by age only in the group of all supratentorial strokes [OR 1.04 (1.01–1.08), <i>p</i> = 0.01]. In this cohort of mild to moderate stroke patients, the ORFs differed between the supra- and infratentorial stroke populations.https://www.mdpi.com/2075-1729/15/4/633biomarkerscarotid arterychronic kidney diseasestroke etiologystrokeTroponin |
| spellingShingle | Manuel Bolognese Mareike Österreich Martin Müller Alexander von Hessling Grzegorz Marek Karwacki Lehel-Barna Lakatos Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke Life biomarkers carotid artery chronic kidney disease stroke etiology stroke Troponin |
| title | Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke |
| title_full | Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke |
| title_fullStr | Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke |
| title_full_unstemmed | Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke |
| title_short | Outcome Predictor Differences in Infratentorial and Supratentorial Ischemic Stroke |
| title_sort | outcome predictor differences in infratentorial and supratentorial ischemic stroke |
| topic | biomarkers carotid artery chronic kidney disease stroke etiology stroke Troponin |
| url | https://www.mdpi.com/2075-1729/15/4/633 |
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