Predicting Outcomes in Acute Ischemic Stroke Using MRI
Author Information
Author(s): Shelagh B Coutts, Michael D Hill, Misha Eliasziw, Karyn Fischer, Andrew M Demchuk
Primary Institution: University of Calgary
Hypothesis
The usefulness of acute MRI in predicting outcome would depend on whether the event was related to stroke progression or to a distinct recurrent stroke within 2 years of symptom onset, or to death.
Conclusion
Different imaging factors predict stroke progression versus stroke recurrence, with baseline hyperglycemia consistently predicting all three outcomes regardless of stroke severity.
Supporting Evidence
- 8.7% of patients experienced stroke progression within 2 years.
- 8.0% had recurrent strokes, and 6.6% died within the same period.
- Admission hyperglycemia was consistently predictive of stroke outcomes.
Takeaway
Doctors can use MRI scans to tell if a stroke will get worse or happen again, and high blood sugar can make things worse.
Methodology
Patients with ischemic stroke or TIA were prospectively enrolled and assessed with MRI within 24 hours of symptom onset, followed for 2 years.
Potential Biases
The ability to image neck vessels with MR angiography was only available halfway through the study.
Limitations
This is a single centre observational study, and the cause of death was not captured.
Participant Demographics
The median age was 70 years, with a range from 18 to 95 years; 68.6% were in the mild stroke/TIA category.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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