Potentially reversible factors during the very acute phase of stroke and their impact on the prognosis: Is there a large therapeutic potential to be explored?

In the Copenhagen Stroke Study, we evaluated the combined impact on stroke outcome of potentially treatable factors such as acute body temperature, bl ood glucose, and stroke in progression. The patients were stratified into t wo groups: Il)patients with 'good' prognostic parameters (body temperature on admission less than or equal to 37.0 degreesC and plasma glucose on admi ssion less than or equal to 6.5 mmol/l and who did not develop stroke in pr ogression) and (2) patients with correspondingly 'poor' prognostic paramete rs. A poor outcome was observed in 4% of The patients with good prognostic parameters versus in 49% of the patients with poor prognostic parameters (p < 0.01), In the multivariate analysis which also included stroke severity, blood glucose contributed significantly to poor outcome with an odds ratio (OR) of 1.2/1.0 mmol/l increase, body temperature with an OR of 2,2/1<degr ees>C increase, and stroke in progression with an OR of 2.9. However, the c ombined effect of all three factors was more than additive with an OR of 10 .0 (95% Cl 1.5-56; p < 0.01), We have shown that in human stroke a strong a nd more than additive association exists between potentially reversible par ameters and outcome. Intervention trials can prove whether these marked rel ations are causal. Copyright <(c)> 2001 S.Karger AG, Basel.