Factors Predicting Functional Outcome in Patients with Acute Ischemic Stroke

Abstract

Background: Stroke remains one of the leading causes of morbidity and mortality worldwide. Identifying predictors of functional outcome in acute ischemic stroke (AIS) patients is crucial for guiding management and prognosis.

Methods: This prospective observational study was conducted in the Department of Neurology at BSMMU, Dhaka, over a 12- month period following ethical approval. A total of 114 AIS patients were enrolled. Detailed history, clinical examination, and relevant investigations were performed with attention to predefined study variables. Functional outcome was assessed at 90 days using the modified Rankin Scale (mRS) by the principal investigator. Data were collected through a semi-structured questionnaire and analyzed using SPSS version 24.0.

Results: The mean age of participants was 60.7 ± 13.5 years, with a male predominance (62% male, 38% female). Of the 114 patients, 71 (62.3%) achieved a good outcome (mRS 0–2), while 43 (37.7%) had a poor outcome (mRS 3–6). Multivariate logistic regression of variables with p < 0.2 in univariate analysis revealed that dyslipidemia, NIHSS score at admission, and mRS score at discharge independently predicted functional outcome (p < 0.05). ROC analysis demonstrated that NIHSS at admission (AUC 0.793, 95% CI 0.704–0.882) and mRS at discharge (AUC 0.867, 95% CI 0.799–0.935) were strong predictors of poor outcome.

Conclusion: Dyslipidemia, higher NIHSS score at admission, and mRS score at discharge significantly predicted poor functional outcome in AIS patients. Larger multicenter studies are recommended to validate these findings.