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CHARACTERISTICS OF ISCHEMIC WAKE-UP STROKE AND UNKOWN-ONSET STROKE IN THE NATIONWIDE NORWEGIAN STROKE REGISTER
Abstract
Background and Aims
Previous studies indicate that patients with wake-up stroke (WUS) are similar to patients with known onset stroke (KOS), but may differ from patients with unknown-onset stroke (UOS). We compared risk factors and clinical characteristics in patients with ischemic WUS, UOS, and KOS from a large national stroke register.
Methods
We included patients registered in the Norwegian Stroke Register from 2012 to 2019. Information on age, gender, risk factors, medication and clinical characteristics were compared between patients with ischemic WUS, UOS and KOS.
Results
Of the 52 134 ischemic strokes, 19.8 % were WUS and 17.7% UOS. Patients with UOS were older (76.6 years, SD 12.6) than patients with WUS (73.6, SD 13.0) and KOS (73.5, SD 13.5). A higher proportion were women (50.3% vs. 43.0% in WUS and 44.8% in KOS) and lived alone (52.5% in the OUS group vs. 36.6% in both WUS and KOS groups). After adjustment for age and sex, atrial fibrillation was more frequent among UOS patients. Other cerebrovascular risk factors did not substantially differ between groups. WUS patients had milder strokes compared to UOS and KOS, while more UOS patients had NIHSS > 15 and reduced level of consciousness on admission.
Conclusions
WUS patients shared baseline characteristics with KOS, but tended to have milder strokes. UOS patients were older and larger proportions were women, lived alone, had atrial fibrillation and severe strokes compared to WUS and KOS patients. The results indicate that WUS and UOS should be considered separate entities.