Abstract P259: Novel Risk Factors and Management Strategies for Transient Ischemic Attack and Stroke: The Inova Fairfax Stroke Database

INTRODUCTION Several studies suggest that obstructive sleep apnea (OSA) is a novel risk factor for cerebrovascular and cardiovascular disease. The Berlin Questionnaire (BQ) which is an inexpensive screen for OSA was used in the current study to examine potential associations between OSA (as measured by BQ), stroke and transient ischemic attack (TIA). METHODS During the 2008 calendar year 1,434 stroke and/or TIA patients were evaluated by the stroke response nurses at Inova Fairfax Hospital. Although the original sample size provided by the Inova staff was 1,433, not all of the patients responded to the BQ. Of the 1,433 cases, 113 were eliminated because they had non-unique responses. Of the remaining cases, 60 cases were left that provided complete responses to the BQ and had no missing values. STATISTICAL ANALYSIS We focused only on two outcomes, ischemic stroke and TIA. Demographic variables: Gender, race (white and non-white), and age. Descriptive statistics were performed for all variables. Univariate analyses were performed and associations between the dependent variables and the predictors were analyzed using exact tests. Logistic regression models were built to identify any potential risk factors for TIA and ischemic stroke. RESULTS In this sample, approximately 28.3% were females and 71.6% were male. The sample was composed of 65% white and 35% non-white patients. The average age of the entire sample was 65.6 years (SD= 13.2 years). Further, 23.3% were identified as having TIA, 55.5% had suffered ischemic stroke while 21.6% had other type of stroke or no diagnosis. Exact tests of significance failed to detect any significant associations between stroke type and OSA as measured by BQ. Furthermore, we did not find any significant associations or differences between age, race, gender, OSA and the outcome variables. Findings from the binary logistic regression models did not identify any significant predictors of TIA and ischemic stroke. CONCLUSIONS Although in this study we did not find a significant association between OSA, TIA and ischemic stroke, we recommend that this study be replicated with larger samples. An analysis of the cause of such low number of complete responses will follow as well.