Significance of aphasia after first-ever acute stroke: impact on early and late outcomes (Journal article)

Tsouli, S./ Kyritsis, A. P./ Tsagalis, G./ Virvidaki, E./ Vemmos, K. N.


BACKGROUND: We assessed the incidence and determinants of aphasia attributable to first-ever acute stroke. We also investigated early and long-term mortality and 1-year dependence in post-stroke patients. METHODS: A 10-year prospective hospital-based study was conducted in the prefecture of Athens, Greece. RESULTS: In total, 2,297 patients were included in the study, of whom 806 (35.1%) had aphasia. The presence of aphasia was independently associated with increasing age (OR: 1.19 per 10-year increase, 95% CI: 1.12-1.21) and atrial fibrillation (OR: 1.35, 95% CI: 1.08-1.67), and inversely associated with Scandinavian Stroke Scale (SSS) score (OR: 0.55 per 10-point increase, 95% CI: 0.52-0.59) and hypertension (OR: 0.77, 95% CI: 0.63-0.96). One-year dependence score (calculated with the modified Rankin score) was higher in aphasic patients compared to non-aphasics (p < 0.001). Moreover, severity of aphasia (estimated with a subscale of SSS) was found as an independent predictor of 1-year dependence. Most of the deaths in the aphasic patients were attributed to infections and neurological damage. Using the Kaplan-Meier limit method, the unadjusted probability of 10-year mortality was demonstrated to increase with the severity of aphasia (log-rank test: 233.9, p < 0.001) and, even after adjustment for several other factors, severity of aphasia remained an independent predictor of 10-year mortality. CONCLUSIONS: Increasing age, atrial fibrillation and severity of stroke were associated with the risk of aphasia after stroke. Severity of aphasia is a strong predictor of long-term mortality and dependence of post-stroke patients.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Aged,Aphasia/*etiology/mortality/therapy,Cause of Death,Cohort Studies,Female,Glasgow Coma Scale,Greece/epidemiology,Hospitalization,Humans,Hypertension/complications/epidemiology,Kaplan-Meier Estimate,Male,Proportional Hazards Models,Prospective Studies,Risk Factors,Stroke/*complications/mortality/therapy,Treatment Outcome
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/18281
ISSN: 1423-0208
Link: http://www.ncbi.nlm.nih.gov/pubmed/19494550
http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000222091
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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