Abstract Background and aims 1.1-10.8% of ischemic strokes occur in patients already hospitalised for another disease, so called in-hospital ischemic stroke (IHIS). Patients with IHIS have higher rates of disability and death at discharge, compared to patients with community onset ischemic stroke (COIS). We aimed to describe outcomes among Swedish IHIS patients. Methods This nationwide retrospective cohort study included all adult stroke patients in Sweden between 2010-2019 registered in the Swedish Stroke Register (Riksstroke). IHIS were compared to COIS regarding comorbidities, stroke severity, treatment, functional outcomes and death. Variables were retrieved from Riksstroke, the Swedish National Patient Register, and the Swedish Cause of Death register. Results 198864 strokes were included, of which 11420 (5.7%) were IHIS. Atrial fibrillation, previous myocardial infarction, peripheral vascular disease, heart failure, renal failure and cancer were more prevalent among IHIS. A larger proportion of IHIS patients had decreased level of consciousness (22.6% vs 12.7%) and a higher median NIHSS score at presentation (7 vs 3) compared with COIS. Thrombolysis rates were similar (10.7% and 10.8%), while median onset-to-needle time was respectively 80 and 125 minutes for IHIS and COIS. The primary outcome, death or dependency 90 days post stroke, occurred more frequently among IHIS patients compared to COIS (55.7% vs 29.5%, OR 3.02, 2.89-3.14), even after adjusting for comorbidities, stroke severety and treatment variables (aOR 2.62 2.48-2.76). Conclusions Patients with IHIS had higher risk of death and dependency 90 days post stroke compared to COIS, despite similar thrombolysis rates and shorter onset-to-needle time. Conflict of interest Ilan Ben-Shabat: Nothing to disclose, David Darehed: Nothing to disclose, Marie Eriksson: Nothing to disclose, Jonatan Salzer: Nothing to disclose
Ben-Shabat et al. (Fri,) studied this question.