Predictors and outcomes of ischemic stroke in reversible cerebral vasoconstriction syndrome

Aayushi Garg; Matthew Starr; Marcelo Rocha; Santiago Ortega-Gutierrez

doi:10.1007/s00415-021-10456-2

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Predictors and outcomes of ischemic stroke in reversible cerebral vasoconstriction syndrome

Journal article

Peer reviewed

Predictors and outcomes of ischemic stroke in reversible cerebral vasoconstriction syndrome

Aayushi Garg, Matthew Starr, Marcelo Rocha and Santiago Ortega-Gutierrez

Journal of neurology, Vol.268(8), pp.3020-3025

08/2021

DOI: 10.1007/s00415-021-10456-2

PMID: 33646329

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Abstract

The clinical factors predisposing to ischemic stroke in reversible cerebral vasoconstriction syndrome (RCVS) are unclear. In this observational cross-sectional study, we aimed to evaluate the risk factors and clinical outcomes associated with the development of ischemic stroke in patients with RCVS. We utilized the Nationwide Readmissions Database 2016-2017 to identify all hospitalizations with RCVS, with or without acute ischemic stroke. Independent predictors of and clinical outcomes associated with ischemic stroke were analyzed using logistic regression. Among 1065 hospitalizations for RCVS (mean ± SD age 49.0 ± 16.7 years, female 69.7%), 267 (25.1%) had ischemic stroke. Patients with ischemic stroke were more likely to have hypertension (OR 2.33, 95% CI 1.51-3.60), diabetes (OR 1.81, 95% CI 1.11-2.98), and tobacco use (OR 1.64, 95% CI 1.16-2.33) and were less likely to have a history of migraine (OR 0.56, 95% CI 0.35-0.90). Ischemic stroke was associated with higher odds of cerebral edema (OR 3.15, 95% CI 1.31-7.57) and respiratory failure (OR 2.39, 95% CI 1.28-4.44). Patients with ischemic stroke also had longer hospital stay by a mean duration of 6.7 days, P < 0.001, higher hospital charges by a mean of $72,961, P < 0.001, and a higher likelihood of not being discharged to home (OR 3.57, 95% CI 2.39-5.33). They had higher in-hospital mortality rate; however, the difference was not statistically significant. Ischemic stroke affects nearly 25% of patients with RCVS and is associated with adverse clinical outcomes. RCVS patients with cerebrovascular risk factors might have a higher predisposition for developing ischemic lesions during the disease process.

Adult

Aged

Brain Ischemia - complications

Brain Ischemia - epidemiology

Female

Humans

Ischemic Stroke

Male

Middle Aged

Stroke - complications

Stroke - epidemiology

Vasoconstriction

Vasospasm, Intracranial

Details

Title: Subtitle: Predictors and outcomes of ischemic stroke in reversible cerebral vasoconstriction syndrome
Creators: Aayushi Garg - University of Iowa
Matthew Starr - University of Pittsburgh Medical Center
Marcelo Rocha - University of Pittsburgh Medical Center
Santiago Ortega-Gutierrez - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Journal of neurology, Vol.268(8), pp.3020-3025
DOI: 10.1007/s00415-021-10456-2
PMID: 33646329
NLM abbreviation: J Neurol
ISSN: 0340-5354
eISSN: 1432-1459
Language: English
Date published: 08/2021
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984302203902771

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