Eur J Neurol. 2023 Jan 27. doi: 10.1111/ene.15699. Online ahead of print.
ABSTRACT
BACKGROUND: To evaluate the temporal trends, characteristics and in-hospital outcomes of patients hospitalized with acute ischemic stroke (AIS) between those with and without current or historical malignancies.
METHODS: Adult hospitalizations with a primary diagnosis of AIS were identified from the National inpatient sample 2007-2017. Logistic regression was used to compare the differences in the utilization of AIS interventions and in-hospital outcomes. For further analysis, subgroup analyses were performed stratified by cancer subtypes.
RESULTS: There were 892,862 hospitalizations due to AIS, of these, 108,357 (12.14%) had a concurrent diagnosis of current cancer (3.41%) or historical cancer (8.72%). After adjustment for confounders, patients with current malignancy were more likely to have worse clinical outcomes. The presence of historical cancers was not associated with an increase in poor clinical outcomes. Additionally, AIS patients with current malignancy were less likely to receive intravenous thrombolysis (IVT) [(aOR): 0.66, 95% CI: 0.63-0.71]. Among the subgroups of AIS patients treated with IVT or mechanical thrombectomy (MT), outcomes varied by cancer types. Notably, despite these acute stroke interventions, outcome remains poor in AIS patients with lung cancer.
CONCLUSIONS: Although AIS patients with malignancy generally have worse in-hospital outcomes versus those without, there were considerable variations in these outcomes according to different cancer types and the use of AIS interventions. Finally, treatment of these AIS patients with a current or historical cancer diagnosis should be individualized.
PMID:36704907 | DOI:10.1111/ene.15699
