Analysis of Clinical Symptoms and Risk Factors Related to Functional Prognosis in Patients With Cardiogenic Stroke

Background: Cardiogenic stroke is associated with substantial morbidity and mortality, necessitating a better understanding of its clinical characteristics for improved patient outcomes. This study aimed to identify clinical characteristics influencing short-term functional prognosis in patients with cardiogenic stroke.

Methods: The study prospectively enrolled 212 patients with cardiogenic stroke, collecting their clinical data and laboratory results. The modified Rankin Scale score at 90 days was used to define functional prognosis, with patients having a good prognosis (modified Rankin Scale ≤2; n = 164) or poor prognosis (modified Rankin Scale ≥3; n = 48).

Results: The poor prognosis group had higher rates of total anterior circulation infarcts (12.5% vs 0.0%; P < .001) and posterior circulation infarction (50.0% vs 38.4%; P < .001) compared with the good prognosis group. Lesion characteristics differed significantly, with the poor prognosis group exhibiting more large-area lesions (39.6% vs 18.9%; P < .001) and multiple confluent lesions (56.3% vs 24.4%; P < .001). Admission-based National Institute of Health Stroke Scale scores were higher in the poor prognosis group (median [IQR], 12 [8-18] vs 5 [4-7]; P <.001), correlating with worse outcomes. The admission National Institute of Health Stroke Scale score predicted patients' 90-day prognosis with good accuracy (area under the curve, 0.937 [95% CI, 0.895-0.965]; P < .001), with a threshold of 7 yielding 85.42% sensitivity and 85.37% specificity.

Conclusion: Higher admission National Institute of Health Stroke Scale scores were significantly associated with poor functional prognosis at 90 days, highlighting the importance of early National Institute of Health Stroke Scale-based assessment for improved outcomes.