RT Journal Article
SR Electronic
T1 Cryptogenic stroke
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 396
OP 405
DO 10.1212/CPJ.0000000000000736
VO 10
IS 5
A1 Shyam Prabhakaran
A1 Steven R. Messé
A1 Dawn Kleindorfer
A1 Eric E. Smith
A1 Gregg C. Fonarow
A1 Haolin Xu
A1 Xin Zhao
A1 Barbara Lytle
A1 Joaquin Cigarroa
A1 Lee H. Schwamm
YR 2020
UL http://cp.neurology.org/content/10/5/396.abstract
AB Background Nationwide data on patients with cryptogenic stroke (CS) are lacking. We evaluated patient and hospital characteristics, in-hospital treatments, and discharge outcomes among patients with CS compared with other subtypes in the Get With The Guidelines (GWTG)-Stroke registry.Methods We identified patients with ischemic stroke (IS) admitted to GWTG-Stroke participating hospitals between January 1, 2016, and September 30, 2017, with documented National Institutes of Health Stroke Scale (NIHSS) scale and stroke etiology (cardioembolic [CE], large artery atherosclerosis [LAA], small vessel occlusion [SVO], other determined etiology [OTH], or CS). Using multivariable logistic regression, we compared hospital treatments and discharge outcomes by subtype, adjusted for patient and hospital characteristics.Results Among 316,623 patients from 1,687 hospitals, there were 63,301 (20.0%) patients with CS. In multivariable analysis, patients with CS received IV thrombolysis more often than other subtypes and had lower mortality than CE, LAA, and OTH but higher mortality than SVO. They were more likely to be discharged home than all other subtypes and be independent at discharge than LAA, OTH, or SVO.Conclusions In a large contemporary nationwide registry, CS accounted for 20% of ISs among patients with a documented stroke etiology. Patients with CS had a distinct profile of treatments and outcomes relative to other subtypes. Improved subtype documentation and further research into CS are warranted to improve care and outcomes for patients with stroke.