Temporal trends and outcomes in acute ischaemic stroke patients with a current or historical diagnosis of cancer. (14th February 2023)

• Record Type: Journal Article
• Authors: Peng, Chi; Yang, Fan; Peng, Liwei; Zhang, Chenxu; Lin, Zhen; Chen, Chenxin; Gao, Huachen; He, Jia; Jin, Zhichao
• Is Part Of: European journal of neurology. Volume 30:Number 4(2023)
• Page Start: 951
• Page End: 962
• Publication Date: 2023-02-14
• Subjects: acute ischaemic stroke -- AIS -- clinical outcomes -- current cancer -- historical cancer; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.15699
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: The aim was to evaluate the temporal trends, characteristics and in‐hospital outcomes of patients hospitalized with acute ischaemic 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 database 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 which 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 (adjusted odds ratio 0.66, 95% confidence interval 0.63–0.71). Amongst the subgroups of AIS patients treated with intravenous thrombolysis or mechanical thrombectomy, 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.