The current status and issue of in-hospital stroke

Abstract

Background and purpose: The aim of the present study was to clarify the clinical characteristics of in-hospital stroke, under the introducing thrombolysis and thrombectomy. Patients and Methods: From January 2013 to May 2016, 24 consecutive patients with in-hospital stroke from the 39,877 patients who were hospitalized in our hospital were included in this study. Results: The clinical types of stroke were 1) cerebral infarction was the higher in 18 patients, 2) intracerebral hemorrhage in four patients, and 3) subarachnoid hemorrhage in two patients. The major subtypes of cerebral infarction were cardioembolic stroke in eight patients, iatrogenic stroke in five patients, and atherothrombotic infarction in two patients. Although the median modified Rankin Scale (mRS) on admission was 1.5, that of at discharge was worsen to 4. Conclusions: In-hospital stroke onset was not uncommon. The neurological deficits in patients with in-hospital stroke were severe and the outcome was worse. In-hospital stroke was more common in patients with an emergency hospitalization than planned hospitalization. Iatrogenic cerebral infarction is a feature of in-hospital stroke in this study. The patients with in-hospital cerebral infarction quite often have some contraindications to the acute intravenous thrombolysis treatment. In such cases, the thrombectomy should be considered.