Background: To explore the effects of onset time of electrocardiogram (ECG) abnormalities at an early stage of acute ischemic stroke on patient prognosis. Cardiac dysfunction after stroke is a challenge for clinicians. This is a retrospective study of patients in the neurology departments of 23 hospitals in Shanghai and Wuhan, China.
Methods: The medical records of 351 patients were compared. Chi-square, Kruskal-Wallis, Mann-Whitney U tests, and stratification compared subgroups. Logistic regressions analyzed factors associated with modified Rankin Scale (mRS) score.
Results: ECG abnormalities occurred in 70.1% of patients at an early stage (most were within 48 hours of disease onset) at least once, whereas 45.9% of the patients had ECG abnormalities within 48 hours of onset and at 7 days after onset. The incidence of poor prognosis (mRS >1) was significantly higher in the patients with ECG abnormalities for both time points than that in those with normal ECGs (56.3% versus 32%, odds ratio = 2.166). Most patients demonstrated 1 to 2 ECG abnormalities, and very few patients had 3 or more. Increasing number of ECG abnormalities was mirrored by poorer prognosis. ECG abnormalities occurred within 48 hours and at the seventh day after onset of acute ischemic stroke; the abnormalities that appeared within 48 hours and were still found on the seventh day after onset of the disease were independent predictors of poor patient prognosis.
Conclusions: The incidence of abnormal ECGs was high in the patients with acute ischemic stroke, and the abnormal ECGs could appear at any stage of the disease.
Keywords: Acute ischemic stroke; ECG; continuous electrocardiogram abnormalities; modified Rankin Scale (mRS); prognosis.
Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.