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.

Details

Title
4C Mortality Score correlates with in-hospital functional outcome after COVID-19-associated ischaemic stroke
Author
Sawczyńska, Katarzyna 1 ; Wnuk, Marcin 2 ; Jagiełła, Jeremiasz 2 ; Kęsek, Tomasz 3 ; Wolska-Sikora, Magdalena 4 ; Szara-Cichoń, Magdalena 4 ; Zagata-Szewczyk, Kinga 5 ; Uchacz, Adela 5 ; Filipowicz, Katarzyna 5 ; Plaszczak, Marcin 5 ; Spisak-Borowska, Katarzyna 6 ; Baranowska, Anna 7 ; Wójcik-Pędziwiatr, Magdalena 8 ; Swarowska-Skuza, Marta 8 ; Szczygieł-Pilut, Elżbieta 8 ; Kłos, Mariusz 9 ; Grzyb, Piotr 9 ; Biela, Michał 9 ; Mierzwińska, Joanna 4 ; Sinkiewicz, Iwona 5 ; Machowski, Jerzy 6 ; Węgrzyn, Anna 7 ; Michalski, Michał 8 ; Nowak, Ryszard 9 ; Słowik, Agnieszka 2 

 Department of Neurology, Jagiellonian University Medical College, Krakow, Poland. [email protected] 
 Department of Neurology, Jagiellonian University Medical College, Krakow, Poland 
 Department of Neurology, University Hospital in Krakow, Poland 
 Department of Neurology, Henryk Klimontowicz Specialist Hospital, Gorlice, Poland 
 Department of Neurology, John Paul II Podhale Specialist Hospital, Nowy Targ, Poland 
 Department of Neurology, Saint Maximillian County Hospital, Oswiecim, Poland 
 Department of Neurology, Jedrzej Sniadecki Specialist Hospital, Nowy Sacz, Poland 
 Department of Neurology, John Paul II Specialist Hospital, Krakow, Poland 
 Department of Neurology, Ludwik Rydygier Specialist Hospital, Krakow, Poland 
First page
295
End page
299
Publication year
2021
Publication date
2021
Publisher
Wydawnictwo Via Medica
ISSN
00283843
e-ISSN
18974260
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2692732430
Copyright
© 2021. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.