Background and Aims:
Post-stroke aphasia (PSA) poses a significant challenge as only a limited number of studies have investigated its impact on stroke prognosis, including functional morbidity and mortality.
Methods:
This single-center retrospective study involved ischemic stroke cases admitted within 7 days of onset between January 2011 and December 2023 from NCVC stroke registry. PSA was defined based on the language sub-score of the NIHSS at discharge. The effect of aphasia at discharge on modified Rankin Scale (mRS) deterioration at 3 months and 1 year and mortality was assessed by multivariable analysis, adjusting for age, sex, mRS at discharge, comorbidities, transfer to rehabilitation, and antithrombotic drugs use.
Results
A total of 6,271 cases (mean age:74.3 ±12.3 years, female:38.1%) included cardioembolic (27.6%), atherothrombotic (16.7%), lacunar (17.2%), and other strokes (38.5%). Follow-up rates were 100% at 3 months and 77.5% at 1 year. At discharge, median mRS was 2 (IQR 1-4), with aphasia in 17.7%. Worsening of mRS was observed in 21.7% at 3 months and 23.8% at 1 year. Multivariable analyses revealed significant associations between PSA and poor prognosis at 3 months (OR 2.24, 95% CI 1.89-2.66) and 1 year (OR 1.70, 95% CI 1.40-2.06). Mortality was also significant at 3 months (OR 2.85, 95% CI 2.05-3.97) and 1 year (OR 2.36, 95% CI 1.84-3.02).
Conclusions
PSA independently predicted poor functional morbidity and mortality at 3 months and 1 year. The presence of PSA should be recognized as an independent predictor of poor prognosis in stroke.