Comparison of Palpability of Lower Limb Pulses with Early Outcome after Acute Ischemic Stroke

Abstract

Purpose:

Aim of this study Aim of this explorative study was to compare pulse palpability of lower legs arteries and early outcome within the first week after admission due to acute ischemic stroke (AIS).

Materials and Methods:

2 155 patients (m:f=1 166:989; age: median=69; min=18, max=98 years, Body Mass Index: median=26.0, min=14.9, max=61.9 kg/m²) with ischemic stroke and all 8 pulses checked within the first week were included in this cohort study explorative cohort study. Pulse palpability of left and right lower legs arteries was compared with medical complications within 1 week after admission, the National Institute of Health Stroke Scale 24–36 h after admission (NIHSS), and the modified Rankin Scale at 5–7 days after admission (mRS).

Results:

Significant associations between increased risk for heart failure (p=0.011), urinary infection (p=0.016), ischemic stroke (p=0.030), fever (p=0.049) and bad pulse palpability were observed.

The correlation between mRS and bad pulse palpability was marginally significant (r_S=0.041, p=0.056). The correlation between NIHSS and bad pulse palpability was slightly higher and correlation was statistically significant (r_S=0.095, p<0.0001).

Conclusions:

In the present study, significant correlations between bad pulse palpability of lower limb arteries and heart failure, urinary infection, ischemic stroke, fever, NIHSS, and marginally with mRS could be shown, respectively. This seems to indicate a poor early outcome of patients with “bad” pulse palpability after AIS. Pulse palpation as a simple, cost-effective, and time sparing examination, is recommended to help to prevent cardiac events in some cases after AIS.

Zusammenfassung

Fragestellung:

Ziel der vorliegenden vorliegenden explorativen Studie war der Vergleich zwischen der Tastbarkeit der Pulse der unteren Extremitäten und dem „Outcome“ innerhalb der ersten Woche nach ischämischem Schlaganfall.

Material und Methoden:

Die Studie wurde im Rahmen der Wiener Schlaganfalldatenbank durchgeführt. 2 155 Patienten (m:f=1 166:989; Alter: Median=69; Min=18, Max=98 Jahre, Body-Mass-Index: Median=26,0, Min=14,9, Max=61,9 kg/m²) mit ischämischem Schlaganfall wurden in diese explorative Kohortenstudie eingeschlossen. Die Tastbarkeit der Pulse der unteren Extremitäten wurde mit den innerhalb der ersten Woche nach Schlaganfall auftretenden Komplikationen, und der Skalen „National Institute of Health Stroke Scale“ 24–36 Stunden nach Ereignis (NIHSS) und modifizierten „Rankin Scale“ 5–7 Tage nach Ereignis (mRS) verglichen.

Ergebnisse:

Statistisch signifikante Zusammenhänge zwischen den Komplikationen Herzin­suffizienz, (p=0,011), Harnwegsinfekt (p=0,016), ischä­mischer Schlaganfall (p=0,030), Fieber (p=0,049) und der schlechten Pulstastbarkeit der unteren Extremitäten wurden beobachtet. Die Korrelation zwischen mRS und der der schlechten Pulstastbarkeit war grenzwertig signifikant (r_S=0,041, p=0,056).

Die Korrelation zwischen NIHSS und den untersuchten Pulsen war leicht stärker ausgeprägt und signifikant (r_S=0,095, p<0,0001).

Schlussfolgerungen:

Es konnten signifikante Korrelationen zwischen der Tastbarkeit der Pulse der unteren Extremitäten und den Komplikationen Herzinsuffizienz, Harnwegsinfekt, ischämischer Schlaganfall, Fieber, den Scores NIHSS und grenzwertig mit mRS innerhalb der ersten Woche nach ischämischem Insult gezeigt ­werden. Diese Resultate scheinen einen Zusammenhang zwischen ­schlechter Pulstastbarkeit und dem „Early Outcome“ nach ischämischem Schlaganfall zu zeigen.

Key words

ischemic stroke - pulse palpability - early outcome - complications - mobilization

Schlüsselwörter

ischämischer Schlaganfall - Pulstastbarkeit - „Early Outcome“ - Komplikationen

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