학술논문

Stroke in patients with cancer in the era of hyperacute stroke intervention.
Document Type
Article
Source
Internal Medicine Journal. Sep2022, Vol. 52 Issue 9, p1513-1518. 6p.
Subject
*STROKE diagnosis
*EVALUATION of medical care
*STROKE
*RETROSPECTIVE studies
*TERTIARY care
*ACQUISITION of data
*CANCER patients
*THROMBECTOMY
*HOSPITAL wards
*MEDICAL records
*SURVIVAL analysis (Biometry)
*DESCRIPTIVE statistics
*ENDOVASCULAR surgery
*TISSUE plasminogen activator
Language
ISSN
1444-0903
Abstract
Background: The natural history of patients with stroke and cancer remains poorly understood in the modern era of hyperacute stroke therapies (recombinant tissue plasminogen activator and endovascular clot retrieval (ECR)). Prior to these advances in stroke treatment, a highly cited study reported median overall survival (mOS) 4.5 months after stroke in a cohort of patients with cancer (2004, n = 96). Aims: Our hypothesis is that patients with stroke and cancer have better outcome than in earlier studies. Methods: Retrospective analysis of admission to a tertiary Stroke Unit between January 2015 and September 2017 (n = 1910), evaluation of hospital records and cancer treatment records. Cancer was categorised as early stage (Stages I and II) and advanced stage (Stage III or IV) using the RD‐Staging system. Survival analysis was performed in R. Results: There were 143 stroke patients with cancer (62% male) with mean age 73.2 ± 12.5 years. Ischaemic stroke occurred in 74.1% and 45 of 106 (42.5%) patients received intravenous thrombolysis (34/45) and/or ECR (11/45). One patient who received ECR died within 30 days of stroke. Those with early stage disease had mOS of 19.6 months (interquartile range (IQR) 3.1–31.5 months) and in advanced stage cancer mOS was 2.5 months (IQR 0.4–6.3 months; P < 0.01). Conclusion: In the modern era of stroke therapy, our cohort of patients with advanced cancer has lower survival post‐stroke compared to those with early stage cancer. [ABSTRACT FROM AUTHOR]