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Prognostic significance of international normalised ratio and prothrombin time in Chinese acute ischaemic stroke patients
  1. Shoujiang You1,
  2. Qiao Han2,
  3. Xiaofeng Dong3,
  4. Chongke Zhong4,
  5. Huaping Du5,
  6. Yaming Sun6,
  7. Yongjun Cao1,7,
  8. Chunfeng Liu1,7
  1. 1Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
  2. 2Department of Neurology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu, China
  3. 3Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
  4. 4Department of Epidemiology, Medical College of Soochow University, Suzhou, Jiangsu, China
  5. 5Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou, Jiangsu, China
  6. 6Department of Neurology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu, China
  7. 7Institutes of Neuroscience, Soochow University, Suzhou, Jiangsu, China
  1. Correspondence to Dr Yongjun Cao, Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; yongjuncao{at}126.com

Abstract

Background We investigated the association between international normalised ratio (INR) and prothrombin time (PT) levels on hospital admission and in-hospital outcomes in acute ischaemic stroke (AIS) patients.

Methods A total of 3175 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. We divided patients into four groups according to their level of admission INR: (<0.92), Q2 (0.92–0.98), Q3 (0.98–1.04) and Q4 (≥1.04) and PT. Logistic regression models were used to estimate the effect of INR and PT on death or major disability (modified Rankin Scale score (mRS)>3), death and major disability (mRS scores 4–5) separately on discharge in AIS patients.

Results Having an INR level in the highest quartile (Q4) was associated with an increased risk of death or major disability (OR 1.69; 95% CI 1.23 to 2.31; P-trend=0.001), death (OR, 2.64; 95% CI 1.12 to 6.19; P-trend=0.002) and major disability on discharge (OR, 1.56; 95% CI 1.13 to 2.15; P-trend=0.008) in comparison to Q1 after adjusting for potential covariates. Moreover, in multivariable logistic regression models, having a PT level in the highest quartile also significantly increased the risk of death (OR, 2.38; 95% CI 1.06 to 5.32; P-trend=0.006) but not death or major disability (P-trend=0.240), major disability (P-trend=0.606) on discharge.

Conclusions High INR at admission was independently associated with death or major disability, death and major disability at hospital discharge in AIS patients and increased PT was also associated with death at hospital discharge.

  • neurology
  • stroke medicine
  • vascular medicine

Data availability statement

Data are available on reasonable request. The datasets during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Data availability statement

Data are available on reasonable request. The datasets during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Footnotes

  • SY and QH contributed equally.

  • YS and YC contributed equally.

  • Contributors SY, YS and YC contributed to the concept and rationale for the study. SY and QH were responsible for the first draft; SY and CZ contributed statistical analyses. XD, HD, QH, SY and YS performed the data collection; YC and CL for the first revision; YC as the guarantor for this study;all authors read and approved the final manuscript.

  • Funding This work was supported in part by grants from the National Natural Science Foundation of China (81901198), The diagnosis and treatment technology for key clinical diseases in Suzhou (LCZX201806), the Suzhou Traditional Chinese Medicine Key specialist construction projects (202011), Discipline Construction Programme of the Second Affiliated Hospital of Soochow University (XKTJ-XK202001and XKTJ-TD202004). This work was also partly supported by the Young Elite Scientists Sponsorship Program by China Association for Science and Technology (2018QNRC001).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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