Factors affecting post-ischemic stroke mortality in cancer patients

• Published in: Japanese Journal of Stroke Vol. 44; no. 3; pp. 252 - 258
• Main Authors: Akasu, Yukari, Yamauchi, Junji, Yamano, Yoshihisa, Tsuchihashi, Yoko, Shimizu, Takahiro, Imai, Takeshi, Akiyama, Hisanao, Hasegawa, Yasuhiro
• Format: Journal Article
• Language: English; Japanese
• Published: The Japan Stroke Society 2022
• Subjects: cancer; D-dimer; deep venous thrombosis; ischemic stroke
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.10968

Background and Purpose: Determining the factors associated with post-stroke survival and prognosis in cancer patients is important for treatment selection. However, there has been no clear evidence related to markers that can predict mortality. Therefore, in this study, we analyzed the factors associated with post-stroke mortality in patients with cancer. Methods: Specifically, this was a retrospective cohort study that included cancer patients with acute ischemic stroke hospitalized at Kawasaki Municipal Tama Hospital between January 2009 and March 2021. To evaluate the associations between clinical factors within 24 hours of initial stroke and mortality or stroke recurrence events within 6 months after stroke onset, logistic analysis was used. Further, in each study group, cutoff points for the markers of mortality were determined using receiver operating characteristic (ROC) curve analysis, and cumulative outcome rate was compared using Kaplan-Meier analysis. Results: A total of 94 cancer patients who developed acute stroke were ultimately selected for analysis, wherein 40 (42.5%) subjects died within 6 months following stroke onset. On assessment, high D-dimer levels and deep venous thrombosis (DVT) were independently associated with mortality, in which a higher death rate was significantly confirmed in the group with D-dimer levels ≥4.1 mg/dl. Conclusion: Furthermore, cancer patients with stroke, high D-dimer levels, and DVT would be associated with the risk of mortality within 6 months after stroke onset.