scholarly journals P.064 Delays in the emergency department for stroke patients, medical complications and predictors of outcomes: the McGill experience

2016 ◽  
Vol 43 (S2) ◽  
pp. S36-S36
Author(s):  
C Legault ◽  
B Chen ◽  
L Vieira ◽  
B Lo (Montreal) ◽  
L Wadup ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Outcomes ◽  
Stroke Unit ◽  
Best Practice ◽  
Brain Oedema ◽  
Medical Complications ◽  
Significant Delay ◽  
Stroke Patients ◽  
Risk Of Death ◽  
Increased Risk

Background: The Canadian Stroke Best Practice recommends admission of patients to a specialised stroke unit within three hours. We aimed at assessing delays in our emergency department (ED) and correlating these with medical complications and clinical outcomes. Methods: Predictors and outcomes This is a retrospective review of patients (n=353) admitted with ischemic strokes (January 2011-March 2014). We assessed the length of stay in ED, medical complications in ED and in the stroke unit, functional status (modified Rankin Scale) at discharge and survival. Results: The median delay in ED was 13.8 hours. The rate of medical complications in the ED was 14% (most common being delirium), compared to the stroke unit with 46.7% (most common being pneumonia). Worse functional outcome was correlated with diagnosis of pneumonia (standardised β coefficient=0.2, p=0.001) and presence of brain oedema in the stroke unit (standardised β coefficient=0.2, p<0.01). Increased risk of death was correlated with brain oedema (OR=649.2, 95%CI=19-2184, p<0.01) and sepsis in the stroke unit (OR=26.8, 95%CI=2.1-339, p<0.01). Conclusions: We found a significant delay in the admission of our patients from the ED to the stroke unit, which is not in keeping with the present guidelines. Medical complications were correlated with worse outcomes. Future analyses will correlate ED delays with clinical outcomes.

scholarly journals Cross-sectional observational study of epidemiology of COVID-19 and clinical outcomes of hospitalised patients in North West London during March and April 2020

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044384
Author(s):  
Guduru Gopal Rao ◽  
Alexander Allen ◽  
Padmasayee Papineni ◽  
Liyang Wang ◽  
Charlotte Anderson ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Outcomes ◽  
Severe Infection ◽  
Older Age ◽  
Cross Sectional ◽  
North West ◽  
Icu Admission ◽  
Risk Of Death ◽  
Hospitalised Patients ◽  
Increased Risk

ObjectiveThe aim of this paper is to describe evolution, epidemiology and clinical outcomes of COVID-19 in subjects tested at or admitted to hospitals in North West London.DesignObservational cohort study.SettingLondon North West Healthcare NHS Trust (LNWH).ParticipantsPatients tested and/or admitted for COVID-19 at LNWH during March and April 2020Main outcome measuresDescriptive and analytical epidemiology of demographic and clinical outcomes (intensive care unit (ICU) admission, mechanical ventilation and mortality) of those who tested positive for COVID-19.ResultsThe outbreak began in the first week of March 2020 and reached a peak by the end of March and first week of April. In the study period, 6183 tests were performed in on 4981 people. Of the 2086 laboratory confirmed COVID-19 cases, 1901 were admitted to hospital. Older age group, men and those of black or Asian minority ethnic (BAME) group were predominantly affected (p<0.05). These groups also had more severe infection resulting in ICU admission and need for mechanical ventilation (p<0.05). However, in a multivariate analysis, only increasing age was independently associated with increased risk of death (p<0.05). Mortality rate was 26.9% in hospitalised patients.ConclusionThe findings confirm that men, BAME and older population were most commonly and severely affected groups. Only older age was independently associated with mortality.

Abstract T P259: What Should Really be Happening to Our Stroke Patients Post-Acute Care?: A System Best Practice Model for Inpatient Rehab

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Shelley Sharp ◽  
Elizabeth Linkewich ◽  
Jacqueline Willems ◽  
Nicola Tahair ◽  
Charissa Levy ◽  
...  
Keyword(s):  
Acute Care ◽  
Stroke Unit ◽  
Best Practice ◽  
Patient Flow ◽  
System Capacity ◽  
Stroke Patients ◽  
Practice Model ◽  
Term Care ◽  
Stroke Unit Care ◽  
The Right

Background: A regional Stroke Report Card identified poor performance on system efficiency, effectiveness, and integration of stroke best practice. This engaged regional funders and 17 organizations (11 acute, 6 rehab) to collaborate in stroke system planning. The focus included stroke unit care and access to timely and appropriate rehabilitation, including increased access for severe stroke. Changes in acute care, including pre-hospital, have facilitated access to stroke unit care in the city. A model of patient flow from acute care was needed to understand other system capacity needs. Purpose: To use best practice and benchmarks to delineate post-acute patient flow and facilitate alignment of resources for inpatient rehabilitation. Methods: Administrative data from national reporting and local rehab referral system databases were used to review current system usage from acute care. A model of proportional distribution of cases from acute, specifically to inpatient rehab, was established using provincial benchmarks, evidence informed targets, and organization market share of total inpatient rehab system capacity. Iterative discussions were required to confirm the organizations’ commitment to stroke best practice. New volume and case mix changes were applied to determine capacity and resource planning needs across organizations. Results: The best practice model, approved by all stakeholders, proposes 40% of stroke patients discharged alive from acute care should access inpatient, 13% outpatient rehabilitation and 6% to Complex Continuing Care and Long Term Care. Current practice is 26%, <5% and 13% respectively. A projected volume increase of 278 patients is distributed across 5/6 rehab providers. This results in a total proportional system shift from 20% (n=160) to 41.5% (n =446) of severe patients receiving access to high intensity rehab. A reduction in the overall proportion of moderate and mild stroke patients from 65% (519) to 49.5% (n=534) and 15% (n=119) to 9% (n=96) respectively. Conclusion: Significant investment/redistribution of resources within the system is required to support patient flow and provide care in the right place at the right time. System funder support is critical to create a quality of care (best practice) system.

scholarly journals Genetic Variations in the PI3K/PTEN/AKT/mTOR Pathway Are Associated With Clinical Outcomes in Esophageal Cancer Patients Treated With Chemoradiotherapy

2009 ◽  
Vol 27 (6) ◽  
pp. 857-871 ◽  
Author(s):  
Michelle A.T. Hildebrandt ◽  
Hushan Yang ◽  
Mien-Chie Hung ◽  
Julie G. Izzo ◽  
Maosheng Huang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Genetic Variations ◽  
Chemotherapeutic Agents ◽  
Response To Therapy ◽  
Nucleotide Polymorphisms ◽  
Chemotherapeutic Regimen ◽  
Risk Of Death ◽  
Increased Risk

Purpose The phosphoinositide-3-kinase (PI3K), phosphatase and tensin homolog (PTEN), v-akt murine thymoma viral oncogene homolog (AKT), and mammalian target of rapamycin (mTOR) signaling pathway has been implicated in resistance to several chemotherapeutic agents. In this retrospective study, we determined whether common genetic variations in this pathway are associated with clinical outcomes in esophageal cancer patients with adenocarcinoma or squamous cell carcinoma who have undergone chemoradiotherapy and surgery. Patients and Methods Sixteen tagging single nucleotide polymorphisms (SNPs) in PIK3CA, PTEN, AKT1, AKT2, and FRAP1 (encoding mTOR) were genotyped in these patients and analyzed for associations with response to therapy, survival, and recurrence. Results We observed an increased recurrence risk with genetic variations in AKT1 and AKT2 (hazard ratio [HR], 2.21; 95% CI, 1.06 to 4.60; and HR, 3.30; 95% CI, 1.64 to 6.66, respectively). This effect was magnified with an increasing number of AKT adverse genotypes. In contrast, a predictable protective effect by PTEN genetic variants on recurrence was evident. Survival tree analysis identified higher-order interactions that resulted in variation in recurrence-free survival from 12 to 42 months, depending on the combination of SNPs. Genetic variations in AKT1, AKT2, and FRAP1 were associated with survival. Patients homozygous for either of the FRAP1 SNPs assayed had a more than three-fold increased risk of death. Two genes—AKT2 and FRAP1—were associated with a poor treatment response, while a better response was associated with heterozygosity for AKT1:rs3803304 (odds ratio, 0.50; 95% CI, 0.25 to 0.99). Conclusion These results suggest that common genetic variations in this pathway modulate clinical outcomes in patients who undergo chemoradiotherapy. With further validation, these results may be used to build a model of individualized therapy for the selection of the optimal chemotherapeutic regimen.

scholarly journals Preterm Nutrition and Clinical Outcomes

2020 ◽  
Vol 7 ◽  
pp. 2333794X2093785
Author(s):  
Netsanet Workneh Gidi ◽  
Amha Mekasha ◽  
Assaye K. Nigussie ◽  
Robert L. Goldenberg ◽  
Elizabeth M. McClure ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Preterm Infants ◽  
Enteral Feeding ◽  
Low Income ◽  
Neonatal Intensive Care ◽  
Low Income Countries ◽  
Preterm Neonates ◽  
Risk Of Death ◽  
Increased Risk ◽  
Preterm Formula

Background. In low-income countries, preterm nutrition is often inadequately addressed. The aim of the study was to assess the patterns of feeding and associated clinical outcomes of preterm neonates admitted to neonatal intensive care units in Ethiopia. Method. This was a multicenter, prospective study. Infants’ clinical characteristics at birth, daily monitoring of feeding history, and weight measurements were collected. An outcome assessment was completed at 28 days. Result. For this analysis, 2560 infants (53% male) were eligible. The mean (SD) gestational age was 33.1 (2.2) weeks. During the hospital stay the proportion of infants on breast milk only, preterm formula, term formula, and mixed feeding was 58%, 27.4%, 1.6%, and 34.1%, respectively. Delay in enteral feeding was associated with increased risk of death (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.33-2.78; P < .001) and (OR = 5.06, 95% CI = 3.23-7.87; P < .001) for 1 to 3 and 4 to 6 days of delay in enteral feeding, respectively, after adjusting for possible confounders. The length of delay in enteral feeding was associated with increased risk of hypoglycemia (OR = 1.2, 95% CI = 1.1-1.2; P = .005). The mortality rate was lower in hospitals providing preterm formula more often ( P = .04). Half of the infants continued losing weight at the time of discharge. Conclusion. Delayed enteral feeding significantly increases the risk of mortality before discharge and hypoglycemia in preterm infants in resource-limited settings. Ensuring adequate nutritional support of preterm infants is highly needed.

scholarly journals Undernourished children presenting to an urban emergency department of a tertiary hospital in Tanzania: a prospective descriptive study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Prosper J. Bashaka ◽  
Hendry R. Sawe ◽  
Victor Mwafongo ◽  
Juma A. Mfinanga ◽  
Michael S. Runyon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Fatality ◽  
Descriptive Study ◽  
High Rate ◽  
World Health ◽  
Mortality Data ◽  
Children Under Five ◽  
Under Five ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background: Childhood undernutrition causes significant morbidity and mortality in low- and middle-income countries (LMICs). In Tanzania, the in-hospital prevalence of undernutrition in children under five years of age is approximated to be 30% with a case fatality rate of 8.8%. In Tanzania, the burden of undernourished children under five years of age presenting to emergency departments (EDs) and their outcomes are unknown. This study describes the clinical profiles and outcomes of this population presenting to the emergency department of Muhimbili National Hospital (ED-MNH), a large, urban hospital in Dar es Salaam, Tanzania. Methods This was a prospective descriptive study of children aged 1–59 months presenting to the ED-MNH over eight weeks in July and August 2016. Enrolment occurred through consecutive sampling. Children less than minus one standard deviation below World Health Organization mean values for Weight for Height/Length, Height for Age, or Weight for Age were recruited. Structured questionnaires were used to document primary outcomes of patient demographics and clinical presentations, and secondary outcomes of 24-h and 30-day mortality. Data was summarised using descriptive statistics and relative risks (RR). Results A total of 449 children were screened, of whom 34.1% (n = 153) met criteria for undernutrition and 95.4% (n = 146) of those children were enrolled. The majority of these children, 56.2% (n = 82), were male and the median age was 19 months (IQR 10–31 months). They presented most frequently with fever 24.7% (n = 36) and cough 24.0% (n = 35). Only 6.7% (n = 9) were diagnosed with acute undernutrition by ED-MNH physicians. Mortality at 24 h and 30 days were 2.9% (n = 4) and 12.3% (n = 18) respectively. A decreased level of consciousness with Glasgow Coma Scale below fifteen on arrival to the ED and tachycardia from initial vital signs were found to be associated with a statistically significant increased risk of death in undernourished children, with mortality rates of 16.1% (n = 23), and 24.6% (n = 35), respectively. Conclusions In an urban ED of a tertiary referral hospital in Tanzania, undernutrition remains under-recognized and is associated with a high rate of in-hospital mortality.

scholarly journals Impact of Delirium and Its Motor Subtypes on Stroke Outcomes

Stroke ◽  
2021 ◽  
Vol 52 (4) ◽  
pp. 1322-1329
Author(s):  
Ivã Taiuan Fialho Silva ◽  
Pedro Assis Lopes ◽  
Tiago Timotio Almeida ◽  
Saint Clair Ramos ◽  
Ana Teresa Caliman Fontes ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Functional Dependence ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Risk Of Death ◽  
Increased Risk ◽  
And Behavior ◽  
The Relationship

Background and Purpose: Delirium is an acute and fluctuating impairment of attention, cognition, and behavior. Although common in stroke, studies that associate the clinical subtypes of delirium with functional outcome and death are lacking. We aimed to evaluate the influence of delirium occurrence and its different motor subtypes over stroke patients’ prognosis. Methods: Prospective cohort of stroke patients with symptom onset within 72 hours before research admission. Delirium was diagnosed by Confusion Assessment Method for the Intensive Care Unit, and its motor subtypes were defined according to the Richmond Agitation-Sedation Scale. The main outcome was functional dependence or death (modified Rankin Scale>2) at 90 days comparing: delirium versus no delirium patients; and between motor subtypes. Secondary outcomes included modified Rankin Scale score >2 at 30 days and 90-day-mortality. Results: Two hundred twenty-seven patients were enrolled. Delirium occurred in 71 patients (31.3%), with the hypoactive subtype as the most frequent, in 41 subjects (57.8%). Delirium was associated with increased risk of death and functional dependence at 30 and 90 days and higher 90-day mortality. Multivariate analysis showed delirium (odds ratio, 3.28 [95% CI, 1.17–9.22]) as independent predictor of modified Rankin Scale >2 at 90 days. Conclusions: Delirium is frequent in stroke patients in the acute phase. Its occurrence—specifically in mixed and hypoactive subtypes—seems to predict worse outcomes in this population. To our knowledge, this is the first study to prospectively investigate differences between delirium motor subtypes over functional outcome three months poststroke. Larger studies are needed to elucidate the relationship between motor subtypes of delirium and functional outcomes in the context of acute stroke.

scholarly journals 294. Surveillance for Potential Post-Acute COVID-19 Syndrome Medical Complications in the Emergency Department (ED) – A Retrospective Longitudinal Study of ED Patients Who Had Evidence of SARS-CoV-2 Infection Versus Those Who Did Not

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S254-S255
Author(s):  
Isabel Lake ◽  
Richard C Wang ◽  
Richard E Rothman ◽  
Oliver Laeyendecker ◽  
Reinaldo Fernandez ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Signs ◽  
Supplemental Oxygen ◽  
Cox Proportional Hazards ◽  
Johns Hopkins Hospital ◽  
Medical Complications ◽  
Clinical Complications ◽  
Laboratory Markers ◽  
Increased Risk ◽  
Ed Visits

Abstract Background As the COVID-19 pandemic continues, growing attention has been placed on whether patients previously infected with SARS-CoV-2 have an increased risk of developing and/or exacerbating medical complications. Our study aimed to determine whether individuals with previous evidence of SARS-CoV-2 infection prior to their current emergency department (ED) visit were more likely to present with specific clinical sign/symptoms, laboratory markers, and/or clinical complications. Methods A COVID-19 seroprevalence study was conducted at Johns Hopkins Hospital ED (JHH ED) from March 16 to May 31, 2020. Evidence of ever having SARS-CoV-2 infection (PCR positive or IgG Ab positive) was found in 268 ED patients at this time (i.e. infected and/or previously infected). These patients were matched 1:2 to controls, by date, to other patients who attended the JHHED. Clinical signs/symptoms, laboratory markers, and/or clinical complications associated with ED visits and/or hospitalizations at JHH within 6 months after their initial ED visit was abstracted through chart review for these 804 patients. Cox proportional hazards regression analyses were performed. Results Among 804 ED patients analyzed, 50% were female, 56% Black race, and 15% Hispanic with a mean age of 47 years. 323 (40%) patients had at least 1 subsequent ED visit and additional 70 (9%) had been admitted to JHH. After controlling for race and ethnicity, patients with evidence of current or prior COVID-19 infection were more likely to require supplemental oxygen [hazards ratio (HR) =2.53; p=0.005] and have a cardiovascular complication [HR =2.13; p=0.008] during the subsequent ED visit than the non-infected patients. Conclusion Our findings demonstrate that those previously infected with SARS-CoV-2 have an increased frequency of cardiovascular complications and need for supplemental oxygen in ED visits in the months after their initial SARS-CoV-2 infection was detected. EDs could serve as a critical surveillance site for monitoring post-acute COVID-19 syndrome complications. Disclosures Richard E. Rothman, PhD, MD, Chem bio (Grant/Research Support)

Abstract T MP79: Correlation Between ST Segment Abnormalities at Admission and Worse Neurologic Outcome 90 Days After Stroke: a Prospective Trial

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Gabriel P Braga ◽  
Renato S Gonçalves ◽  
Luiz Eduardo G Betting ◽  
Marcos F Minicucci ◽  
Rodrigo Bazan ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Stroke Unit ◽  
Prospective Trial ◽  
Neurologic Outcome ◽  
Clinical Aspects ◽  
Cardiac Complications ◽  
Stroke Patients ◽  
St Segment ◽  
Increased Risk

Introduction: Cerebrovascular diseases are important causes of disability and death. Cardiovascular diseases and stroke share most of the risk factors and there is an intense relation between cerebral and cardiac homeostasis. Electrocardiogram can be used as measurement of neurogenic cardiac abnormalities as it has been suggested that lesions in the insula may result in abnormal electrocardiographic (ECG) findings and increased risk of sudden death. We assessed the hypothesis that electrocardiographic changes in acute stroke could predict neurological outcome at 90 days Methods: It was a longitudinal prospective study, with stroke patients admitted in an acute Stroke Unit from March 2012 to March 2013. We included all stroke patients within 24h of symptom onset and diagnosis confirmed with head CT scans. We excluded patients with history of cardiac surgery, myocardial infarct and pulmonary thromboembolism within 2 weeks before stroke. We collect data about clinical history and demography, admission NIHSS score and ECG. All patients were followed and in hospital complications, length of stay and modified Rankin score at 90 days were registered. Follow up visits were done by a Neurologist blinded to admission ECG findings; and ECG were analyzed by a Cardiologist blinded to clinical aspects. Statistical analysis was done with logistic regression with correction to gender, admission NIHSS, presence of clinical complications and blood pressure control. Results: Of 247 admitted to stroke unit, 112 fulfilled inclusion criteria and agreed to participate. It was observed positive correlation between ST segment abnormalities on admission ECG and cardiac complications during hospitalization (OR 4.73, IC(95%) 1.49 - 14.98, p: 0.008), worse neurologic outcome at 90 days measured by Rankin 3 - 6 (OR 3.4, IC(95%) 1.07-11.12, p: 0.038), and death at the end of follow up (OR 4.25, IC(95%) 1.17-15.49, p: 0.028). Conclusions: In conclusion, this study showed that ECG findings at admission, especially ST segment abnormalities, were correlated to higher chance of in hospital cardiac complications, worse neurologic outcomes and mortality at 90 days.

Abstract 10895: The Association of Growth Patterns and Clinical Outcomes in Children With Dilated Cardiomyopathy: A Report From the Pediatric Cardiomyopathy Registry Study Group

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Chesney Castleberry ◽  
John L Jefferies ◽  
Ling Shi ◽  
James D Wilkinson ◽  
Jeffrey A Towbin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dilated Cardiomyopathy ◽  
Clinical Outcomes ◽  
Growth Patterns ◽  
Outcome Analysis ◽  
Time To Death ◽  
Risk Of Death ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Pediatric Cardiomyopathy

Introduction: Although malnourishment is associated with mortality in adult dilated cardiomyopathy (DCM), a paradox exists where obesity is protective. We aim to look at the role of these risk factors in pediatric DCM. Hypothesis: We hypothesize malnourishment (MN) and obesity are risk factors for death or heart transplantation. Methods: The NHLBI- funded Pediatric Cardiomyopathy Registry (PCMR) database was used for this analysis of patients (age < 18 years) with idiopathic or familial DCM and myocarditis. Patients were categorized by anthropological measurements: MN (defined as BMI <5% for ≥2years or weight for length <5% for <2 years), obese (BMI> 95% for ages ≥2years or weight for length >95% for <2 years), and normal. Results: Of 904 DCM patients, 23.7% (214) were MN, 13.3% (120) were obese, and 63.1% (570) were normal (Table). Obese patients were significantly older (p<0.001) and more likely to have a family history of DCM (both p<0.05). MN were more likely to have congestive heart failure, increased cardiac dimensions, and higher ventricular mass (p<0.01). In a Kaplan Meier analysis, there was a difference in time to death or transplant by groups (Figure, p=0.0498). Adjusting for age and myocarditis, MN was associated with increased risk of death (HR: 1.857, 95%CI: 1.159-2.977, p=<0.001), but obesity was not (HR: 1.362, 95%CI: 0.722, 2.566). Competing outcome analysis showed an increased risk of death for MN (p=0.026) but no difference between groups in transplant rate (p=0.159). Conclusion: Malnourishment is significantly associated with poor clinical outcomes. Unlike adult DCM where obesity is protective, obesity is not associated with improved survival in pediatric DCM.

Mortality and Functionality after Stroke in Patients with Systemic Lupus Erythematosus

2017 ◽  
Vol 44 (11) ◽  
pp. 1590-1596 ◽  
Author(s):  
Marios Rossides ◽  
Julia F. Simard ◽  
Elisabet Svenungsson ◽  
Mia von Euler ◽  
Elizabeth V. Arkema
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Ischemic Stroke ◽  
Risk Ratio ◽  
Functional Impairment ◽  
Lupus Erythematosus ◽  
Hemorrhagic Stroke ◽  
Stroke Patients ◽  
Systemic Lupus ◽  
Risk Of Death ◽  
Increased Risk

Objective.To investigate mortality and functional impairment after stroke in systemic lupus erythematosus (SLE).Methods.Using Swedish nationwide registers, we identified 423 individuals with SLE and 1652 people without SLE who developed a first-ever ischemic or hemorrhagic stroke (1998–2013) and followed them until all-cause death or for 1 year. HR for death after ischemic or hemorrhagic stroke and the risk ratio of functional impairment (dependence in either transferring, toileting, or dressing) 3 months after ischemic stroke were estimated.Results.One year after stroke, 22% of patients with SLE versus 16% of those without SLE died. After ischemic stroke, patients with SLE had an increased risk of death (HR 1.85, 95% CI 1.39–2.45), which was attenuated after controlling for SLE-related comorbidities (HR 1.41, 95% CI 1.04–1.91). Functional impairment at 3 months was increased in SLE by almost 2-fold (risk ratio 1.73, 95% CI 1.16–2.57). After hemorrhagic stroke, patients with SLE had an HR of 2.30 (95% CI 1.38–3.82) for death, which was increased even during the first month.Conclusion.Compared to subjects without SLE, mortality after ischemic stroke increases after the first month in individuals with SLE, and functionality is worse at 3 months. SLE is associated with all-cause death after hemorrhagic stroke even during the first month. A shift of focus to patient functionality and prevention of hemorrhagic strokes is required.

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