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Open AccessArticle

The Lipid Paradox Among Acute Ischemic Stroke Patients-A Retrospective Study of Outcomes and Complications

1
Department of Neurology, Creighton University School of Medicine, Omaha, NE 68124, USA
2
Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
3
Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV 89102, USA
4
Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
5
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
*
Author to whom correspondence should be addressed.
Both authors contributed equally.
Medicina 2019, 55(8), 475; https://doi.org/10.3390/medicina55080475
Received: 24 June 2019 / Revised: 23 July 2019 / Accepted: 13 August 2019 / Published: 13 August 2019
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Abstract

Background and objectives: The Studies have suggested hypercholesterolemia is a risk factor for cerebrovascular disease. However, few of the studies with a small number of patients had tested the effect of hypercholesterolemia on the outcomes and complications among acute ischemic stroke (AIS) patients. We hypothesized that lipid disorders (LDs), though risk factors for AIS, were associated with better outcomes and fewer post-stroke complications. Materials and Method: We performed a retrospective analysis of the Nationwide Inpatient Sample (years 2003–2014) in adult hospitalizations for AIS to determine the outcomes and complications associated with LDs, using ICD-9-CM codes. In 2014, we also aimed to estimate adjusted odds of AIS in patients with LDs compared to patients without LDs. The multivariable survey logistic regression models, weighted to account for sampling strategy, were fitted to evaluate relationship of LDs with AIS among 2014 hospitalizations, and outcomes and complications amongst AIS patients from 2003–2014. Results and Conclusions: In 2014, there were 28,212,820 (2.02% AIS and 5.50% LDs) hospitalizations. LDs patients had higher prevalence and odds of having AIS compared with non-LDs. Between 2003–2014, of the total 4,224,924 AIS hospitalizations, 451,645 (10.69%) had LDs. Patients with LDs had lower percentages and odds of mortality, risk of death, major/extreme disability, discharge to nursing facility, and complications including epilepsy, stroke-associated pneumonia, GI-bleeding and hemorrhagic-transformation compared to non-LDs. Although LDs are risk factors for AIS, concurrent LDs in AIS is not only associated with lower mortality and disability but also lower post-stroke complications and higher chance of discharge to home.
Keywords: stroke; hyperlipidemia; epilepsy; stroke associated pneumonia; gastro-intestinal hemorrhage; hemorrhagic transformation; nationwide inpatient sample; outcomes stroke; hyperlipidemia; epilepsy; stroke associated pneumonia; gastro-intestinal hemorrhage; hemorrhagic transformation; nationwide inpatient sample; outcomes
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Patel, U.; Malik, P.; Dave, M.; DeMasi, M.S.; Lunagariya, A.; Jani, V.B.; Dhamoon, M.S. The Lipid Paradox Among Acute Ischemic Stroke Patients-A Retrospective Study of Outcomes and Complications. Medicina 2019, 55, 475.

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