VALUE OF EARLY VARIABLES AS PREDICTORS OF SHORT-TERM OUTCOME IN PATIENTS WITH ACUTE FOCAL CEREBRAL-ISCHEMIA

Reliable, simple and safe criteria are needed for the early prediction of short-term outcome in patients with acute ischemic stroke. The aim of our study was to evaluate, in terms of their individual and combin ed power; the prognostic value of a few widely available clinical and instrumental variables obtained during the acute phase. The study invo lved 351 consecutive patients who were examined within 48 hours of the ir first ischemic stroke. Eight variables were chosen: age, initial le vel of consciousness, limb paresis, arterial blood pressure, glycemia, the results of electrocardiography and electroencephalography, and th e infarct size revealed by computed tomography. Mortality and disabili ty were evaluated on Day 30, when the variables that significantly cor related with disability were rite severity of limb paresis, electroenc ephalographic abnormalities, infarct size and (less significantly) the level of consciousness and hyperglycemia. There was no statistical co rrelation with blood pressure. Logistic analysis confirmed only infarc t size, the severity of limb paresis and electroencephalographic abnor malities as independent variables. The variables that significantly co rrelated with early death were the severity of limb paresis, infarct s ize, electrocardiographic abnormalities, the level of consciousness, e lectroencephalographic abnormalities and hyperglycemia. More intriguin gly, logistic analysis confirmed only the electroencephalographic and electrocardiographic abnormalities as independent variables. The predi ctive prognostic value of limb paresis, infarct size, the level of con sciousness and hyperglycemia is well known, but we would like to stres s the fact that only a few independent variables are predictive of ear ly death (electroencephalographic and electrocardiographic abnormaliti es) and poor recovery (infarct size, the severity of limb paresis, ele ctroencephalographic abnormalities). The prognostic value of electroen cephalography may express the potential involvement of dynamic non-str uctural phenomena, such as penumbra ischemica and diaschisis.