Hospitalized Prognosis of Ischemic Stroke with COPD: A Propensity Score Matching Study

Purpose: The relationship between chronic obstructive pulmonary disease (COPD) and hospitalized prognosis, in ischemic stroke patients, as well as complications is not well understood. This study aimed to investigate the influence of COPD on inpatient outcomes among ischemic stroke patients.Methods: A retrospective investigation was conducted in 9260 patients with confirmed ischemic stroke, in the First Affiliated Hospital of Shantou University Medical College, from 2013 to 2020. After excluding patients with missing data or hospital discharge within 24 hours, we divided the eligible 9021 patients into two groups based on whether or not they had been diagnosed with COPD. After a 1:3 ratio propensity score matching (PSM) (n=290, COPD group vs n=856, non-COPD group), we compared hospitalized prognosis and complications between two groups.Results: Stroke patients with COPD had a significantly higher rate of non-recovered and deceased patients at discharge (4.1% vs 2.1%, OR=1.972, P=0.023), and a higher risk of infection (66.2% vs 48.3%, OR=2.10, P<0.001), especially pulmonary infection (48.1% vs 32.3%, OR=1.944, P<0.001), compared to stroke patients without COPD. After propensity score matching analysis, the differences were still statistically significant concerning inpatient non-recovery and death (4.1% vs 1.9%; OR=2.266, P=0.031), infection (66.2% vs 52.9%, OR=1.743, P<0.001) and pulmonary infection (48.3% vs 36.6%, OR=1.619, P<0.001).Conclusion: Stroke patients with COPD have poorer hospitalized prognosis, with a higher rate of non-recovered and deceased patients, as well as higher incidence of infection, compared with those without COPD.