Different strokes: differences in the characteristics and outcomes of BCVI and non-BCVI strokes in trauma patients

Article Figures & Data

Table 1

Baseline data for BCVI and non-BCVI stroke

	BCVI stroke Median, N (%) n=21	Non-BCVI stroke Median, N (%) n=78	P value
Age	44 (27 to 55)	71 (58 to 82)	<0.001
Male	7 (33.3%)	46 (59.0%)	0.078
Mechanism			<0.001
MVC	16 (76.2%)	22 (28.2%)
MCC	0 (0%)	0 (0%)
Auto-Ped	2 (9.5%)	2 (2.6%)
Fall	2 (9.5%)	43 (55.1%)
Other/unknown	1 (4.8%)	11 (14.1%)
AIS head	3 (2 to 4)	0 (0 to 3)	<0.001
AIS face	0 (0 to 1)	0 (0 to 0)	0.003
AIS chest	2 (0 to 4)	0 (0 to 3)	0.009
AIS abdomen	0 (0 to 3)	0 (0 to 0)	0.005
AIS extremity	2 (0 to 3)	2 (0 to 3)	0.96
ISS	26 (20 to 34)	11 (8 to 18)	<0.001
BCVI grade*			<0.001
Grade 1	3 (14.3%)	1 (1.3%)
Grade 2	6 (28.5%)	0 (0%)
Grade 3	3 (14.3%)	0 (0%)
Grade 4	9 (42.9%)	3 (3.9%)
Grade 5	0 (0%)	1 (1.3%)
BCVI location			<0.001
Vertebral artery	10 (47.6%)	0 (0%)
Internal carotid artery	11 (52.4%	5 (6.4%)
GCS in ED	8 (3 to 15)	14.5 (9 to 15)	0.028
SBP in ED (mm Hg)	124 (100 to 146)	145 (120 to 169)	0.044
HR in ED (bpm)	94 (84 to 116)	90 (79 to 110)	0.38
Admission laboratory values
Platelets (k/mm³)	263 (209 to 299)	219 (174.5 to 280.5)	0.062
Hematocrit (%)	12.6 (11.7 to 13.7)	12.5 (10.9 to 13.5)	0.31
TEG ACT (s)	113 (97 to 121)	113 (97 to 121)
TEG MA (mm)	67 (66 to 71)	64.5 (58 to 69)
Medical comorbidities
Any medical comorbidity†	12 (57.1%)	66 (84.6%)	0.013
Atrial fibrillation	0 (0%)	14 (18.0%)	0.037
Stroke or TIA‡	0 (0%)	17 (21.8%)	0.020
CAD/MI, CHF, PVD, hyperlipidemia, and HTN	11 (52.4%)	60 (76.9%)	0.053
Pre-hospital ASA or Plavix	1 (4.8%)	12 (15.4%)	0.29
Pre-hospital oral anticoagulant	0 (0%)	10 (12.8%)	0.11

Summary statistics for continuous variables are median and IQR. Associations between characteristics and type of stroke were evaluated by using Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables.
*Five patients in the non-BCVI stroke group had a BCVI present on imaging but not responsible for the ischemic stroke.
†Medical comorbidities include stroke, transient ischemic attack (TIA), atrial fibrillation, coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF), hypertension (HTN), peripheral vascular disease (PVD), hyperlipidemia, cancer, deep venous thrombosis (DVT), pulmonary embolism (PE), dementia, diabetes, end-stage renal disease, morbid obesity, smoker.
‡Pre-existing condition.
ACT, activated clotting time; ED, emergency department; HR, heart rate; MA, maximum amplitude; MCC, motorcycle crash; MVC, motor vehicle crash; SBP, systolic blood pressure; TEG, thromboelastography.

Table 2

Outcomes data for BCVI and non-BCVI stroke

	BCVI stroke Median, N (%) n=21	Non-BCVI stroke Median, N (%) n=78	P value
Hospital LOS (days)	14 (7 to 20)	12 (6 to 20)	0.85
ICU LOS (days)	7 (4 to 10)	3 (1 to 13)	0.29
Ventilator days	4 (0 to 7)	1 (0 to 7)	0.31
Mortality	8 (38.1%)	17 (21.8%)	0.16
% death due to stroke	75%	52.9%	0.26
NIHSS*	10 (2 to 23)	11 (2 to 22)	0.082
Operation with general anesthesia	17 (81%)	41 (52.6%)
Time (h)
ED arrival to BCVI diagnosis (h)	1.4 (1 to 3.6)	n/a
Diagnosis to BCVI treatment (h)	15 (4.3 to 30.6)	n/a
ED arrival to BCVI treatment (h)	18.2 (6.5 to 36)	n/a
BCVI diagnosis to stroke (h)	24 (0 to 90)	n/a
ED arrival to stroke (h)	44 (6.5 to 92.3)	47.3 (7.4 to 120)	0.53
Discharge disposition			0.032
Dead	8 (38.1%)	17 (21.8%)
Home	2 (9.5%)	14 (17.9%)
Rehabilitation	7 (33.3%)	8 (10.3%)
SNF/LTAC†	3 (14.3%)	30 (38.5%)
Hospice	1 (4.8%)	8 (10.3%)
Other	0 (0%)	1 (1.3%)

Summary statistics for continuous variables are median and IQR. Associations between characteristics and type of stroke were evaluated by using Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables. Wald test was used for comparing mortality rates of two types of stroke.
*National Institutes of Health Stroke Scale.
†Skilled nursing facility (SNF) and long-term acute care facility (LTAC) values in parentheses without % are quartiles.
ED, emergency department; ICU, intensive care unit; LOS, length of stay; n/a, not available.