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Sawczyńska K, Wnuk M, Jagiełła J, Kęsek T, Wolska-Sikora M, Szara-Cichoń M, Zagata-Szewczyk K, Uchacz A, Filipowicz K, Plaszczak M, Spisak-Borowska K, Baranowska A, Wójcik-Pędziwiatr M, Swarowska-Skuza M, Szczygieł-Pilut E, Kłos M, Grzyb P, Biela M, Mierzwińska J, Sinkiewicz I, Machowski J, Węgrzyn A, Michalski M, Nowak R, Słowik A. 4C Mortality Score correlates with in-hospital functional outcome after COVID-19-associated ischaemic stroke. Neurol Neurochir Pol 2021; 55:295-299. [PMID: 33949676 DOI: 10.5603/pjnns.a2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY The 4C Mortality Score was created to predict mortality in hospitalised patients with COVID-19 and has to date been evaluated only in respiratory system disorders. The aim of this study was to investigate its application in patients with COVID-19-associated acute ischaemic stroke (AIS). CLINICAL RATIONALE FOR STUDY COVID-19 is a risk factor for AIS. COVID-19-associated AIS results in higher mortality and worse functional outcome. Predictors of functional outcome in COVID-19-associated AIS are required. MATERIALS AND METHODS This was a retrospective observational study of patients with AIS hospitalised in seven neurological wards in Małopolska Voivodship (Poland) between August and December 2020. We gathered data concerning the patients' age, sex, presence of cardiovascular risk factors, type of treatment received, and the presence of stroke-associated infections (including pneumonia, urinary tract infection and infection of unknown source). We calculated 4C Mortality Score at stroke onset, and investigated whether there was a correlation with neurological deficit measured using the National Health Institute Stroke Scale (NIHSS) and functional outcome assessed using the modified Rankin Scale (mRS) at discharge. RESULTS The study included 52 patients with COVID-19-associated AIS. The 4C Mortality Score at stroke onset correlated with mRS (rs = 0.565, p < 0.01) at discharge. There was also a statistically significant difference in the mean 4C Mortality Score between patients who died and patients who survived the stroke (13.08 ± 2.71 vs. 9.85 ± 3.47, p = 0.04). CONCLUSIONS AND CLINICAL IMPLICATIONS 4C Mortality Score predicts functional outcome at discharge in COVID-19-associated AIS patients.
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Affiliation(s)
- Katarzyna Sawczyńska
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland. .,Department of Neurology, University Hospital in Krakow, Poland.
| | - Marcin Wnuk
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.,Department of Neurology, University Hospital in Krakow, Poland
| | - Jeremiasz Jagiełła
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.,Department of Neurology, University Hospital in Krakow, Poland
| | - Tomasz Kęsek
- Department of Neurology, University Hospital in Krakow, Poland
| | | | | | - Kinga Zagata-Szewczyk
- Department of Neurology, John Paul II Podhale Specialist Hospital, Nowy Targ, Poland
| | - Adela Uchacz
- Department of Neurology, John Paul II Podhale Specialist Hospital, Nowy Targ, Poland
| | - Katarzyna Filipowicz
- Department of Neurology, John Paul II Podhale Specialist Hospital, Nowy Targ, Poland
| | - Marcin Plaszczak
- Department of Neurology, John Paul II Podhale Specialist Hospital, Nowy Targ, Poland
| | | | - Anna Baranowska
- Department of Neurology, Jedrzej Sniadecki Specialist Hospital, Nowy Sacz, Poland
| | | | | | | | - Mariusz Kłos
- Department of Neurology, Ludwik Rydygier Specialist Hospital, Krakow, Poland
| | - Piotr Grzyb
- Department of Neurology, Ludwik Rydygier Specialist Hospital, Krakow, Poland
| | - Michał Biela
- Department of Neurology, Ludwik Rydygier Specialist Hospital, Krakow, Poland
| | - Joanna Mierzwińska
- Department of Neurology, Henryk Klimontowicz Specialist Hospital, Gorlice, Poland
| | - Iwona Sinkiewicz
- Department of Neurology, John Paul II Podhale Specialist Hospital, Nowy Targ, Poland
| | - Jerzy Machowski
- Department of Neurology, Saint Maximillian County Hospital, Oswiecim, Poland
| | - Anna Węgrzyn
- Department of Neurology, Jedrzej Sniadecki Specialist Hospital, Nowy Sacz, Poland
| | - Michał Michalski
- Department of Neurology, John Paul II Specialist Hospital, Krakow, Poland
| | - Ryszard Nowak
- Department of Neurology, Ludwik Rydygier Specialist Hospital, Krakow, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.,Department of Neurology, University Hospital in Krakow, Poland
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