Mortality in acute ischemic stroke patients with new cancer diagnosed during the index hospitalization versus after discharge.
Details
Serval ID
serval:BIB_5568A1855FEA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mortality in acute ischemic stroke patients with new cancer diagnosed during the index hospitalization versus after discharge.
Journal
Journal of stroke and cerebrovascular diseases
ISSN
1532-8511 (Electronic)
ISSN-L
1052-3057
Publication state
Published
Issued date
10/2024
Peer-reviewed
Oui
Volume
33
Number
10
Pages
107899
Language
english
Notes
Publication types: Journal Article ; Comparative Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Early diagnosis of previously unknown cancer (i.e., occult cancer) after an acute ischemic stroke (AIS) could result in faster initiation of cancer therapy and potentially improve clinical outcomes. Our study aimed to compare mortality rates between AIS patients with occult cancer diagnosed during the index stroke hospitalization versus those diagnosed after hospital discharge.
Among consecutive AIS patients treated at our stroke center from 2015 through 2020, we identified new cancer diagnoses made within the year after the AIS. We used multivariable Cox regression analyses to evaluate the association between the timing of occult cancer diagnosis (during the AIS hospitalization versus after discharge) and long-term survival.
Of 3894 AIS patients with available long-term follow-up data, 59 (1.5 %) were diagnosed with a new cancer within one year after index stroke. Of these, 27 (46 %) were diagnosed during the index hospitalization and 32 (54 %) were diagnosed after discharge. During a median follow-up of 406 days (interquartile range, 89-1073), 70 % (n = 19) of patients whose cancer was diagnosed during hospitalization had died, compared to 63 % (n = 20) of patients whose cancer was diagnosed after discharge (p= 0.58). In our main multivariable model, there was no difference in long-term mortality between patient groups (adjusted hazard ratio, 1.16; 95 % confidence interval, 0.53-2.52; p= 0.71).
In this analysis, timing of a new cancer diagnosis after AIS did not seem to influence patients' long-term survival. Given the fairly small number of included patients with previously occult cancer, larger multicenter studies are needed to confirm our results.
Among consecutive AIS patients treated at our stroke center from 2015 through 2020, we identified new cancer diagnoses made within the year after the AIS. We used multivariable Cox regression analyses to evaluate the association between the timing of occult cancer diagnosis (during the AIS hospitalization versus after discharge) and long-term survival.
Of 3894 AIS patients with available long-term follow-up data, 59 (1.5 %) were diagnosed with a new cancer within one year after index stroke. Of these, 27 (46 %) were diagnosed during the index hospitalization and 32 (54 %) were diagnosed after discharge. During a median follow-up of 406 days (interquartile range, 89-1073), 70 % (n = 19) of patients whose cancer was diagnosed during hospitalization had died, compared to 63 % (n = 20) of patients whose cancer was diagnosed after discharge (p= 0.58). In our main multivariable model, there was no difference in long-term mortality between patient groups (adjusted hazard ratio, 1.16; 95 % confidence interval, 0.53-2.52; p= 0.71).
In this analysis, timing of a new cancer diagnosis after AIS did not seem to influence patients' long-term survival. Given the fairly small number of included patients with previously occult cancer, larger multicenter studies are needed to confirm our results.
Keywords
Humans, Male, Female, Patient Discharge, Aged, Ischemic Stroke/mortality, Ischemic Stroke/diagnosis, Ischemic Stroke/therapy, Time Factors, Middle Aged, Risk Factors, Aged, 80 and over, Neoplasms/mortality, Neoplasms/diagnosis, Neoplasms/therapy, Neoplasms/complications, Risk Assessment, Retrospective Studies, Prognosis, Patient Admission, Hospitalization, Cancer, Cancer-related stroke, Diagnosis, Mortality, Occult cancer, Outcomes, Stroke
Pubmed
Web of science
Open Access
Yes
Create date
09/08/2024 15:03
Last modification date
24/09/2024 7:23