Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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Kneihsl, M; Enzinger, C; Wünsch, G; Khalil, M; Culea, V; Urbanic-Purkart, T; Payer, F; Niederkorn, K; Fazekas, F; Gattringer, T.
Poor short-term outcome in patients with ischaemic stroke and active cancer.
J Neurol. 2016; 263(1):150-156
Doi: 10.1007/s00415-015-7954-6
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- Führende Autor*innen der Med Uni Graz
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Gattringer Thomas
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Kneihsl Markus
- Co-Autor*innen der Med Uni Graz
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Enzinger Christian
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Fazekas Franz
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Gold Valeriu
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Khalil Michael
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Niederkorn Kurt
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Payer Franz
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Urbanic Purkart Tadeja
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Wünsch Gerit
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- Abstract:
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Stroke risk is increased in cancer patients and cancer activity has been claimed to play a role in the development of ischaemic stroke (IS). We wanted to further test these assumptions and to explore the impact of such relation on short-term prognosis. We identified all IS patients that were admitted to the neurological department of our primary and tertiary care university hospital between 2008 and 2014 (n = 4918) and reviewed their medical records for an additional diagnosis of cancer. Cancer patients were categorized into those with "active cancer" (AC: recurrent malignant tumour, metastases, ongoing chemo-/radiotherapy) and "non-active cancer" (NAC). We compared demographic, clinical and neuroimaging features of both patient groups and assessed their association with in-hospital mortality. 300 IS patients with known cancer were identified (AC: n = 73; NAC: n = 227). IS patients with AC were significantly younger (70.3 ± 10.6 vs. 74.9 ± 9.9 years), had more severe strokes at admission (NIHSS: median 5 vs. 3), more frequently cryptogenic strokes (50.7 vs. 32.5 %) and more often infarcts in multiple vascular territories of the brain (26 vs. 5.2 %) compared to IS patients with NAC. In-hospital mortality was significantly higher in AC patients (21.9 vs. 6.2 %). Multivariate analysis identified AC (odds ratio [OR] 3.70, 95 % confidence interval [CI] 1.50-9.30), NIHSS at admission (OR 1.10, CI 1.10-1.20) and C-reactive protein level (OR 1.01, CI 1.00-1.02) as factors significantly and independently associated with in-hospital death. Our findings support a direct role of AC in the pathogenesis and prognosis of acute IS. This needs to be considered in the management and counselling of such patients.
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Aged -
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Aged, 80 and over -
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Brain Ischemia - epidemiology
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Female -
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Humans -
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Male -
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Middle Aged -
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Neoplasms - epidemiology
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Outcome Assessment (Health Care) - statistics & numerical data
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Stroke - epidemiology
- Find related publications in this database (Keywords)
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Clinical neurology
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Ischaemic stroke
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Cancer
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Outcome