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Influence of Pre-Existing Mild Cognitive Impairment and Dementia on Post-Stroke Mortality. The Dijon Stroke Registry
- Source :
- Neuroepidemiology, Neuroepidemiology, Karger, 2020, 54 (6), pp.490-497. ⟨10.1159/000497614⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- Objective: We assessed the association between pre-stroke cognitive status and 90-day case-fatality. Methods: Patients with ischemic stroke (IS) or spontaneous intracerebral hemorrhage (ICH) were prospectively identified among residents of Dijon, France, between 2013 and 2015, using a population-based registry. Association between pre-stroke cognitive status and case-fatality at 90 days was evaluated using Cox regression. Results: Seven hundred sixty-two patients were identified, and information about pre-stroke cognitive status was obtained for 716 (92.6%) of them, including 603 IS (84.2%) and 113 ICH (15.8%). Before stroke, 99 (13.8%) patients had mild cognitive impairment (MCI) and 98 (13.7%) had dementia. Patients with cognitive impairment were older, had a higher prevalence of several risk factors, more severe stroke, more frequent ICH, and less admission to stroke unit. Case-fatality rate at 90 days was 11.7% in patients without cognitive impairment, 32.3% in MCI patients, and 55.1% in patients with dementia. In multivariable analyses, pre-existing MCI (hazard ratio [HR] 2.22, 95% CI 1.21–4.05, p = 0.009) and dementia (HR 4.35, 95% CI 2.49–7.61, p < 0.001) were both associated with 90-day case-fatality. Conclusion: Pre-stroke MCI and dementia were both associated with increased mortality. These associations were not fully explained by baseline characteristics, pre-stroke dependency, stroke severity or patient management, and underlying reasons need to be investigated.
- Subjects :
- Male
medicine.medical_specialty
Epidemiology
Population
Comorbidity
030501 epidemiology
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Risk Factors
Internal medicine
Case fatality rate
medicine
Dementia
Humans
Cognitive Dysfunction
Prospective Studies
Registries
cardiovascular diseases
Cognitive impairment
education
Stroke
Aged
Aged, 80 and over
education.field_of_study
Proportional hazards model
business.industry
Hazard ratio
medicine.disease
Female
Neurology (clinical)
France
0305 other medical science
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 02515350 and 14230208
- Database :
- OpenAIRE
- Journal :
- Neuroepidemiology, Neuroepidemiology, Karger, 2020, 54 (6), pp.490-497. ⟨10.1159/000497614⟩
- Accession number :
- edsair.doi.dedup.....714607f8ec75acfafa0fe534f72c3346