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(Stroke. 2008;39:2138.)
© 2008 American Heart Association, Inc.

Research Letters

Impact of Comorbidities on Ischemic Stroke Outcomes in Women

Cheryl D. Bushnell, MD, MHS; Jeanne Lee, MD; Pamela W. Duncan, PhD; L. Kristin Newby, MD, MHS Larry B. Goldstein, MD

From the Center for Cerebrovascular Disease, Department of Medicine, Division of Neurology (C.D.B., L.B.G.), Duke University Medical Center; the Department of Medicine (J.L.), Duke University Medical Center; the Division of Physical Therapy, Department of Community and Family Medicine (P.W.D.), Duke University Medical Center and Center for Clinical Health Policy Research; and the Department of Medicine, Division of Cardiology (L.K.N.), Duke Clinical Research Institute, Durham, NC.

Correspondence to Cheryl D. Bushnell, MD, MHS, Department of Neurology, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27157. E-mail cbushnel{at}wfubmc.edu

Abstract

Background and Purpose— We assessed the association of prestroke comorbidities with long-term stroke outcomes among women with ischemic stroke.

Methods— Prestroke comorbid conditions in 133 women admitted with acute ischemic stroke were scored with the Charlson Index (CI). We assessed whether the CI and other specific conditions were associated with modified Rankin Score (mRS) at 90 days or more poststroke.

Results— After adjustment for initial NIHSS and age, higher CI was the sole factor independently associated with poorer 90 day mRS scores. When CI was excluded, coronary disease and diabetes were independently associated with poorer outcome.

Conclusion— The extent of comorbidities as assessed by the CI is independently associated with 90-day mRS among women with ischemic stroke, but the individual comorbidities of CHD and DM were each associated with functional outcome.

Key Words: acute stroke • outcome • stroke recovery • women and minorities • comorbidities