Early consciousness disorder in acute ischemic stroke: incidence, risk factors and outcome

Background: Little is known about the incidence and risk factors of early consciousness disorder (ECD) in patients with acute ischemic stroke, or about how ECD may affect complications and outcomes. Methods: Patients admitted to our hospital within 24 h of onset of acute ischemic stroke were consecutively enrolled. ECD was evaluated clinically and using the Glasgow coma scale. Multivariate analysis was used to identify risk factors of ECD, as well as associations between ECD and clinical outcomes. Results: Of the 569 patients enrolled, 199 (35 %) had ECD. Independent risk factors of ECD were advanced age (OR 1. 027, 95 % CI 1.007 to 1.048), National Institutes of Health Stroke Score on admission (OR 1.331, 95 % CI 1.257 to 1.410), and massive cerebral infarct (OR 3.211, 95 % CI 1.642 to 6.279). ECD was associated with higher frequency of stroke-related complications (83.4 % vs. 31.1 %, P < 0.001) and higher in-hospital mortality (17.1 % vs. 0.5 %, P < 0.001). ECD independently predicted 3-month death/disability (OR 3.272, 95 % CI 1.670 to 6.413). Conclusions: ECD is prevalent in Chinese patients with acute ischemic stroke. Risk factors include advanced age, stroke severity, and massive cerebral infarct. ECD is associated with higher frequency of stroke-related complications and 3-month death/disability.