032Short-term Morbidity Outcomes of Acute Stroke – Comparing Patients in Atrial Fibrillation versus Sinus Rhythm on Admission

Abstract

Background: Acute stroke can be debilitating and short-term morbidity can impact longerterm outcomes. Atrial fibrillation (AF) has been described as a conventional risk factor for stroke, both iscahemic (via cardioembolism) and haemorrhagic (via anticoagulation), and has been linked to poorer outcomes. We aimed to evaluate these observations by comparing short-term morbidity outcomes in patients hospitalised with acute stroke in AF versus SR. Methods: We retrospectively evaluated data of 126 randomly selected patients admitted with acute stroke to a single centre, non-tertiary hospital within a 12-month period. Details of admission demographics, medications, length of stay were collected. Shortterm morbidity was defined as Modified Rankin Score (MRS) on admission and discharge. AF or SR were identified on admission 12-lead electrocardiogram. Results: Baseline demographics show that AF patients were older (80.9 ± 8.0 vs 67.7 ± 15.1 years old, p = 0.0001), had higher use of beta-blockers (31 vs 21%, p = 0.04) and oral anticoagulation (100 vs 0%, p = 0.0001), and had higher left atrial size (4.6 ± 0.7 vs 3.7 ± 0.7 cm, p = 0.0001), compared to the SR group. Despite significantly higher MRS in the AF group compared to SR (4.1 ± 1.1 vs 3.4 ± 1.3, p = 0.03) on admission, there was no significant difference in change of MRS from admission to discharge (-1.2 ± 1.7 vs-1.1 ± 1.1, p = 0.84). Length of hospital stay was not significantly different between groups. Results in mean ± SD. Conclusion: There was no significant difference in short-term morbidity outcome in patients hospitalised with stroke regardless of admission rhythm and anti-coagulation strategy. This may be attributed to the impact of multi-disciplinary post-stroke rehabilitation in a dedicated stroke unit and requires further confirmation.