Abstract Details

Title Management and Outcomes of Stroke in Patients with Parkinson’s Disease

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-008

Background Co-morbid neurological conditions create added barriers to timely diagnosis and effective treatment of stroke. Parkinson’s disease (PD) is the most common neurodegenerative movement disorder and primarily affects older populations who are at increased risk for stroke. There are limited data on how the presence of PD impacts outcomes in stroke patients.

Objective To determine stroke characteristics, management and outcomes in patients with Parkinson’s disease.

Design/Methods We compared stroke characteristics, management and outcomes in patients with and without PD, ascertained using ICD codes and verified through chart review. We used data from the Cornell Acute Stroke Academy Registry (CAESAR) on all patients hospitalized for ischemic stroke at New York-Presbyterian Hospital/Weill Cornell Medical Center from 2011 through 2018. Statistical analysis was calculated using Wilcoxon rank-sum test to compare differences in continuous variables and chi-square/Fisher's exact test for categorical variables.

Results Of the 2945 patients admitted for stroke during the study period, 30 had a confirmed diagnosis of PD. The PD cohort were significantly older (median age 82 vs 73; p=0.01), but groups were otherwise similar in their prevalence of stroke risk factors. Similarly, the initial presentation and treatment of PD patients were indistinguishable from their non-PD peers with similar onset-to-arrival times (3.3 vs 3.0 hours; p=0.98), NIH stroke scale (5 vs 4; p=0.94), thrombolysis administration rates (17% vs 10%; p=0.25), and onset-to-treatment times (1.3 vs 1.9; p=0.22). We found no appreciable difference in stroke mechanism (p=0.36) or ambulatory status at discharge (p=0.98).

Conclusions

In a single-center stroke registry, PD patients presenting with acute ischemic stroke did not have unique risk factor profiles and had similar outcomes to non-PD stroke patients. These data suggest that the presence of co-morbid PD should not impact clinical decision-making for acute stroke treatment and providers should not be limited in their approach to caring for PD patients with stroke.

Authors/Disclosures
Lynda Nwabuobi, MD (The Neurology Center K Street) PRESENTER	Dr. Nwabuobi has received personal compensation in the range of $0-$499 for serving as a Consultant for KX Advisors. Dr. Nwabuobi has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Healthgrades. Dr. Nwabuobi has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Consultant 360.
Chenel Morrison	Miss Morrison has nothing to disclose.
Aryeh Zolin, MD, PhD (NYP-WCM)	Dr. Zolin has nothing to disclose.
	No disclosure on file
Babak Navi, MD (Weill Cornell Medical College)	Dr. Navi has nothing to disclose.
Hooman Kamel, MD (Weill Cornell Medical College)	Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.