Prognostic association between TOAST and functional dependence 90 days after ischemic stroke

The etiologic classification of ischemic stroke according to TOAST is fundamental in stablishing the correct treatment to patients in order to prevent recurring strokes, besides helping to determine their prognosis. Objectives: To determine the relationship between TOAST and functional outcome 90 days after ischemic stroke, using the modified Rankin scale (mRS). Design and Setting: It’s a cross-sectional study with patients from HGRS – Salvador, Bahia. Methods: We classified all patients according to TOAST and stratified the mRS post-90 days in “functional independence” (mRs 0-2) and “functional dependence/death” (mRs 3-6). We included patients > 18 years old, admitted up to 72 hours from ictus, excluding those previously dependent (mRs ≥ 3). We used central tendency measures, chi- squared test and relative risk (RR). We considered IC = 95% and p <0,05 for statistical significance. Results: We included 268 patients. 59 had large-artery atherosclerosis (LAA), 39 small- vessel occlusion (SVO), 74 cardio embolism (CE) and 84 cryptogenic stroke (CS). There was no difference in gravity in admission between the groups nor in functional outcome in 90 days when the etiologies were grouped (p=0,07). Using CS as reference, CE had RR=1,34, LAA RR=1,31, SVO RR=0,99 for functional dependence (mRS ≥ 3) in 90 days. Conclusions: The RR analysis numerically shows that CE and LAA elevated the risk of functional dependence in 90 days in 30%. Bigger studies are required to sensitize the analysis.