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Short-Term Outcome in Stroke Patients with or without Atrial Fibrillation: A Retrospective Case-Control Study

DOI: 10.5402/2012/750394

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Abstract:

Background. Patients with cardioembolic stroke due to atrial fibrillation (CE/AF stroke) seem to have a poorer functional recovery than those with non cardioembolic stroke. This may be ascribed to the heterogeneity between the samples of patients with and without CE/AF stroke. Aim. To compare the short-term outcome of patients with CE/AF stroke and with non-CE/AF stroke of same gender and similar age and level of disability and comorbidity. Methods. The functional independence measure (FIM) of 40 consecutive patients with CE/AF stroke was retrospectively evaluated at admission and discharge in our rehabilitation department. Each “case” was matched with a patient (“control”) of the same sex and similar age and FIM score at admission, affected by non-CE/AF stroke admitted to our department in the same period. Results. FIM score at admission and discharge was respectively 5 1 . 9 ± 2 0 . 3 and 7 5 . 7 ± 2 1 . 2 in patients with CE/AF stroke and 5 4 . 9 ± 1 9 and 7 3 . 9 ± 2 2 . 7 in patients with non-CE/AF stroke; no significant difference was found between the groups. Multivariate analysis showed an effect of the rehabilitation treatment and age on FIM score, whereas no effect was attributable to AF. Conclusions. The short-term outcome is similar in patients with and without CE/AF stroke. 1. Introduction Cardioembolic (CE) strokes account for 25 to 30% of ischemic strokes among white populations [1], most of which are associated with atrial fibrillation (AF). In fact AF is the most common persistent cardiac arrhythmia [2], and its prevalence has been estimated at 1% in the general population [3, 4], ranging from about 1% in people aged between 55 and 59 years to 9–13% in people older than 80 years [4–6]. Previous studies have reported that CE stroke associated with AF (CE/AF stroke) has a poorer prognosis in terms of survival because of the higher risk of early stroke recurrence, the larger volume of the infarct, the existing cardiac disease causing the arrhythmia, and the older age of patients compared to those with other ischemic strokes [7–9]. It has been also reported that patients with CE/AF stroke display a worse functional recovery than those with non-CE/AF stroke [7]. However, such a finding was drawn from the comparison of heterogeneous samples of patients. Hence, it has not been conclusively established the functional outcome of patients with CE/AF stroke. The aim of our study was to compare the short-term outcome of patients with or without CE/AF stroke after removing some confounding factors, such as different sex, age, and level of

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