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Peer-reviewedCC BY-NCMedicine

Factors associated with subtype classification and 3-month functional outcome in ischemic stroke, focusing on large-artery atherosclerosis and small-vessel occlusion : A retrospective observational study

  • Do-Yeon Lee1
  • Chae Rin Baik1
  • Seohee Jang1
  • Jin Kwon1
  • Geunwoo Kim1
  • Hyun Goo Kang2,3
  1. 1Medical Student, Jeonbuk National University Medical School, Jeonju, South Korea
  2. 2Department of Neurology and Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, South Korea
  3. 3Biomedical Research Institute, Jeonbuk National University Medical School and Hospital, Jeonju, South Korea.
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Abstract

Ischemic stroke accounts for a rising share of the total stroke burden. This retrospective observational study aimed to identify factors associated with subtype classification and 3-month functional outcome among patients with ischemic stroke, focusing on large-artery atherosclerosis (LAA) and small-vessel occlusion (SVO). This retrospective study included patients with ischemic stroke admitted to a regional tertiary hospital between 2019 and 2021, who were classified using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Multivariable logistic regression was used to identify factors associated with each subtype (vs all other subtypes) and with an excellent 3-month outcome (modified Rankin Scale [mRS] score 0–1) within the LAA and SVO groups. Among 1823 patients, the etiologies were LAA (30.33%), cardioembolism (18.87%), SVO (41.09%), and other stroke types (9.71%). Female sex (adjusted odds ratio [aOR], 0.71; P = .005) was inversely and age (aOR, 1.02 per year; P < .001) positively associated with LAA, whereas dyslipidemia (aOR, 1.81; P < .001) was positively associated, and ischemic heart disease (aOR, 0.54; P = .023) and older age (aOR, 0.68; P < .001) were inversely associated, with SVO. For an excellent 3-month outcome, female sex was associated with lower odds (aOR, 0.54; P = .003) and obesity with higher odds (aOR, 1.59; P = .015) in the LAA group, whereas age (aOR, 0.97 per year; P < .001) and hypertension (aOR, 0.70; P = .033) were associated with lower odds, and obesity with higher odds (aOR, 1.39; P = .044), in the SVO group. After additional adjustment for initial stroke severity, the associations of female sex, obesity, and age persisted, whereas that of hypertension was attenuated; with functional independence (mRS 0–2) as the outcome, age, hypertension, and obesity were no longer significant. The factors associated with subtype classification and with 3-month functional outcome differ between ischemic stroke subtypes. Because only patients with ischemic stroke were included and the primary outcome models were not adjusted for initial stroke severity, these results are hypothesis-generating and may inform subtype-specific strategies in stroke management and future research.

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Cite

BibTeXRIS
BibTeX
@article{lee2026factors,
  title = {{Factors associated with subtype classification and 3-month functional outcome in ischemic stroke, focusing on large-artery atherosclerosis and small-vessel occlusion : A retrospective observational study}},
  author = {Do-Yeon Lee and Chae Rin Baik and Seohee Jang and Jin Kwon and Geunwoo Kim and Hyun Goo Kang},
  journal = {Medicine},
  year = {2026},
  month = oct,
  doi = {10.1097/md.0000000000051251},
  url = {https://europepmc.org/article/PMC/PMC13727219},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Factors associated with subtype classification and 3-month functional outcome in ischemic stroke, focusing on large-artery atherosclerosis and small-vessel occlusion : A retrospective observational study
AU  - Do-Yeon Lee
AU  - Chae Rin Baik
AU  - Seohee Jang
AU  - Jin Kwon
AU  - Geunwoo Kim
AU  - Hyun Goo Kang
PY  - 2026
DA  - 2026/10/30
JO  - Medicine
DO  - 10.1097/md.0000000000051251
UR  - https://europepmc.org/article/PMC/PMC13727219
AB  - Ischemic stroke accounts for a rising share of the total stroke burden. This retrospective observational study aimed to identify factors associated with subtype classification and 3-month functional outcome among patients with ischemic stroke, focusing on large-artery atherosclerosis (LAA) and small-vessel occlusion (SVO). This retrospective study included patients with ischemic stroke admitted to a regional tertiary hospital between 2019 and 2021, who were classified using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Multivariable logistic regression was used to identify factors associated with each subtype (vs all other subtypes) and with an excellent 3-month outcome (modified Rankin Scale [mRS] score 0–1) within the LAA and SVO groups. Among 1823 patients, the etiologies were LAA (30.33%), cardioembolism (18.87%), SVO (41.09%), and other stroke types (9.71%). Female sex (adjusted odds ratio [aOR], 0.71; P = .005) was inversely and age (aOR, 1.02 per year; P < .001) positively associated with LAA, whereas dyslipidemia (aOR, 1.81; P < .001) was positively associated, and ischemic heart disease (aOR, 0.54; P = .023) and older age (aOR, 0.68; P < .001) were inversely associated, with SVO. For an excellent 3-month outcome, female sex was associated with lower odds (aOR, 0.54; P = .003) and obesity with higher odds (aOR, 1.59; P = .015) in the LAA group, whereas age (aOR, 0.97 per year; P < .001) and hypertension (aOR, 0.70; P = .033) were associated with lower odds, and obesity with higher odds (aOR, 1.39; P = .044), in the SVO group. After additional adjustment for initial stroke severity, the associations of female sex, obesity, and age persisted, whereas that of hypertension was attenuated; with functional independence (mRS 0–2) as the outcome, age, hypertension, and obesity were no longer significant. The factors associated with subtype classification and with 3-month functional outcome differ between ischemic stroke subtypes. Because only patients with ischemic stroke were included and the primary outcome models were not adjusted for initial stroke severity, these results are hypothesis-generating and may inform subtype-specific strategies in stroke management and future research.
SN  - 0304-5412
SN  - 1536-5964
SN  - 0025-7974
ER  -