Incidence of Altered Level of Consciousness in Hemorrhagic Stroke Survivors: Associated Factors From a Korean Nationwide Study
Authors
Nayeon Ko ; Hyun Haeng Lee ; Min Kyun Sohn ; Deog Young Kim ; Yong-Il Shin ; Gyung-Jae Oh ; Yang-Soo Lee ; Min Cheol Joo ; So Young Lee ; Min-Keun Song ; Junhee Han ; Jeonghoon Ahn ; Won Hyuk Chang ; Jongmin Lee ; Yun-Hee Kim
Citation
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION, Vol.103(4) : 325-332, 2024-04
Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Consciousness ; Consciousness Disorders / epidemiology ; Consciousness Disorders / etiology ; Female ; Glasgow Coma Scale ; Hemorrhagic Stroke* ; Humans ; Incidence ; Middle Aged ; Prospective Studies ; Republic of Korea / epidemiology ; Stroke* / complications ; Stroke* / epidemiology ; Young Adult
Abstract
Objective: This study aimed to demonstrate the incidence of altered level of consciousness after hemorrhagic stroke and identify factors associated with altered level of consciousness at 3 mos after stroke. Design: This study used data from a prospective multicenter cohort study conducted in nine hospitals in Korea and included 1677 patients with first-ever hemorrhagic stroke. Patients were dichotomized into those with and without altered level of consciousness at 3 mos after stroke. Multivariate logistic regression analysis was performed to identify factors associated with subacute to chronic stage altered level of consciousness. Results: Among patients with hemorrhagic stroke (age: 20–99 yrs, female 50.21%), the prevalence of altered level of consciousness at admission was 38.58% (25.4% [drowsy], 6.38% [stupor], and 6.8% [coma]) and 17.29% 3 mos after stroke. Multivariate logistic regression analysis revealed that independent factors associated with altered level of consciousness at 3 mos after stroke included late seizure (odds ratio [95% confidence interval], 5.93 [1.78–20.00]), stroke progression (3.84 [1.48–9.64]), craniectomy (2.19 [1.19–4.00]), history of complications (1.74 [1.18–2.55]), age at stroke onset (1.08 [1.07–1.10]), and initial Glasgow Coma Scale score category (0.36 [0.30–0.44]). Conclusions: The factors associated with altered level of consciousness at 3 mos after stroke should be considered when explaining long-term consciousness status and focused management of modifiable factors in acute care hospitals could help ameliorate altered level of consciousness and promote recovery after stroke.