Highlights
- •Elevated E/e' could predict 90-day mortality in patients with ischemic stroke.
- •We developed a clinical score, the DONE score, for prediction of 90-day mortality.
- •The DONE score was consisted of D-dimer, Occlusion of ICA or BA, NIHSS score and E/e'.
- •The mortality was about 30% in patients with the DONE score ≧64.
- •The DONE score also could predict poor outcome at 90 days.
Abstract
Purpose
The aim of this study was to identify whether diastolic dysfunction predicts death
at 90 days after acute ischemic stroke.
Methods
We retrospectively analyzed patients with ischemic stroke. All patients underwent
transthoracic echocardiography to evaluate systolic function and diastolic function
by means of assessing ejection fraction and septal E/e'. We evaluated the initial
National Institute of Health Stroke Scale (NIHSS) score, arterial occlusion, and laboratory
data. We used multivariate regression models to identify independent predictors of
90-day mortality.
Results
Among 1208 patients, the overall 90-day mortality rate was 8%. In multivariate logistic
regression analysis, a higher initial NIHSS score, plasma D-dimer level and E/e',
and occlusion of internal carotid artery or basilar artery were independent predictors
of 90-day mortality. The DONE score derived from these valuables showed good discrimination
with area under the curve (AUC) value of 0.82 (95% confidence interval [CI], 0.78–0.87)
to predict 90-day mortality. The DONE score also predicted poor outcome (modified
Rankin scale score, 4–6) at 90 days (AUC, 0.82; 95% CI 0.80–0.85).
Conclusions
Higher E/e', indicating diastolic dysfunction, may be associated with 90-day mortality
in patients with acute ischemic stroke. The DONE score could readily predict poor
outcome after acute ischemic stroke.
Keywords
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Article info
Publication history
Published online: January 16, 2019
Accepted:
January 14,
2019
Received in revised form:
January 10,
2019
Received:
July 23,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
