Poster Abstracts Thursday, November 10, 2005 $393

(48.8%) were independent (mRS 0-2). Having no peripheral-artery disease was the only independent predictor o f good outcome (adjusted odds ratio [adjOR]: 0.07; 95"/0 CI: 0.01 0.50), and having malignancy (new or recurrent) was the only independent predictor of death (adjOR: 5.59; 95% CI: 1.03 30.20). These results did not differ between symptomatic and asymptomatic patients. Conclusion: The major risk for patients with ICA stenosis _>70% and previous irradiation, is to die from malignancy. This finding should be taken into account when surgery or angioplasty is discussed.

1147 Urgent Carotid hldarterectomy: a prospective non randomised study of 42 cases

Desfontaines, P~, Sakalihassan, N ~. 1CHC-Lidge, Stroke Unit, Department of Neurology, Li@e, Belgium; 2CHC-Li@e, Department of Vascular Surgery', Lidge, Belgium

Background: Benefits of carotid endarterectomy in the prevention of stroke in symptomatic patients with high grade stenosis are well established since Nascet and ESCT studies. Timing of carotid end- arterectomy remains an unsolved question. Previous experiences with carotid endarterectomy advised an arbitrary delay of 4 to 6 weeks before surgery; but delayed endarterectomy exposes the patients to recurrent stroke. Method: Inclusion criteria's were: symptomatic, carotid stenosis of 70% of more, patient with TIA or progressive stroke or minor stroke, no infarct larger than a lacunar infarction on brain ct scan, onset of symptoms within 24 hours before surgery, clinical evaluation by neurologist, general anaesthesia and intraluminal shunting in all cases. Results: 16 TIA and 26 progressive or minor stroke included. Mean age: 71 + / - 7.6 years. Mean European stroke scale before surgery: 74. Mean European stroke scale at discharge: 94. A m o n g the stroke patients, 14/26 had no clinical improvement but no worsening after surgery. 11/26 had significant clinical improvement. 1/26 patient developed a fatal ischemic stroke 24 hours after surgery. No TIA patients worsened after surgery. Conclusion: This study of 42 consecutive patients with symptomatic high grade carotid stenosis shows the feasibility and the safety of performing urgent carotid endarterectomy within 24 hours after the onset of T IA or minor or progressive stroke. Tiffs procedure seems to us justified by the fact that a symptomatic carotid stenosis is an unstable lesion and waiting for surgery may lead to another stroke more disabling for the patient.

1148 Benelit of treatulent in an extended Stroke utfit service combined with a rehabilitation department: a retrospective study

Desfontaines Ph 1, Masson X 2 Debrun A 2 Camelbeeck p3. 1Centre Hospitalier Chrdtien, Neurology Department, Likge, Blegium; 2Centre Hospitalier Chrdtien, Rehabilitation Department, Ligge, Belgium; 3Centre Hospitalier Chrdtien, Emergency Department, Ligge, Belgium

Background: Several trials have shown that stroke unit (SU) care improves outcome for stroke patients. The a n t of this study was to show wlffch aspects o f the SU were most responsible for the better outcome. Method: 178 consecutive acute stroke patients admitted in the SU were compared retrospectively with 134 consecutive acute stroke patients adinitted in General wards (GW). We identified the differences in the investigations, medical and surgical treatments and rehabilitation cares. We analyzed the association of these factors with the outcome. X test and the Student t test were used for statistical analysis. Results: At 3 months, 12.0% of the SU patients were in institutions vs 25.8% of the G W patients (p - 0.03), 77.6% of the SU patients were at home vs 51.7"/o of the G W patients (p -- 0.001). The Barthel's index was above 75 in 82.5"/o o f the SU patients vs 57.3% in the G W patients (p - 0.01). The factors siguificantly different in the SU from

the G W were a s tandard protocol of stroke management not present in the GW, an increased use of anticoagulation (used in 22.4% of the SU patients vs 4.5% in the G W patients, p - 0.001) and a shorter time to start the rehabilitation cares (more than 24 hours after admission in 60"/o of the G W patients vs 28% of the SU patients, p - 0.001). Conclusion: A shorter time to start rehabilitation therapy and the use of a s tandard protocol of stroke management were the most impor- tant factors distinguishing SU from GW, followed by a wider use of anticoagulation.

1149 Gentler ditl~rences in Stroke prevalence, risk factors and outcome: Indian experience

Dhamija, RK 1. 1Lady Hardinge Medical College, New Delhi, India

Demographic profile, risk factors and outcome of stroke has not been studied in south Asian women. Therefore present study was conducted to analyze these epidenffological parameters of stroke in Indian women. A consecutive 267 patients who were admitted with a CT proven diagnosis of stroke in Lady Hardinge Medical College and Hospital New Delhi were studied to ascertain any gender differences in epidemiological parameters. There were 145 female patients in tiffs cohort. The age of female and male patients ranged from 18 85 years and 16 80 years respectively, with a mean age of 53.21 years for females and 55.47 years for males. Ischaernic stroke occurred in 72.42% of female patients as compared to 69.68% of male patients, while haemorragic stroke occurred in 27.58% of these women. Diabetes was present in 38.42% of female patients and in 22.13"/o of male patients wlffle hypertension was associated with 58.16"/o femaleand 44.26% of male patients. 62.2% of these females had associated cardiac diseases and 22.2% had dyslipidemias as compared to 44.26% and 16.2% respectively in males. Durat ion of hospital stay ranged from 3-24 days with an average duration of 5.6 days. Seizures were present in 11.03% of female patients, however only 4.18"/o female patients had pregnancy related seizures. Conclusions: Women have different clinical profile, more associated comoribidies, lack of primary care due to gender bias in this part of world. Hence these factors should be kept in mind while planning primary and secondary prevention strategies for stroke in the communities.

1150 C- reactive protein levels in patients of Acute Stroke and its correlation with Lipids

Dhamija, RK l, Kaintura , A 1, Kumar , M ~. 1Lady Hardinge Medical College, India

Background" Stroke is the third leading cause of death and foremost cause of adult disability. High levels of C-reactive protein have been implicated with increased risk of Arteriosclerosis and ischaemic stroke. The present study was aimed to ascertain role of CRP levels and its correlation with lipids in patients of Ischaernic Stroke. Method- CRP levels were estimated in 76 subjects including 36 CT proven patients of Ischaemic Stroke and 40 age & sex matched controls. The CRP levels were measured senffquantatively by aggluti- nation method. Patients with acute with chronic, infections, Diabetes, Hypertension, Arthritis, and with other causes known to increase CRP levels were excluded from tiffs study. Complete hemato- logical & biochemical parameters including lipids were studied in all subjects. Results- Mean age of patients and controls was 56.48 years and 54.20 years respectively. Raised CRP levels more than 6 mg/L were observed in 43.42% of total subjects. 77.7% of patients and 12.54% of controls had raised CRP levels ( > 6 rag/L). Abnormal lipid levels were found in 55.40% of patients while 22.50"/o of control group had abnormal lipid profiles. Out of 28 patients with raised ClIP levels, 22 (78.50"/o) had abnormal lipid levels wlffle 20% of controls with