Orv Hetil. 2026 Jan 11;167(2):43-50. doi: 10.1556/650.2026.33457. Print 2026 Jan 11.
ABSTRACT
INTRODUCTION: Acute ischemic stroke is one of the leading causes of disability and mortality in adults, representing a major public health burden also in Hungary. Functional recovery is influenced by a wide range of clinical, imaging and vascular risk factors; however, the relative contribution of these predictors is still poorly understood in the Hungarian population.
METHOD: The aim of this study was to identify the independent predictors of a 3-month functional outcome among ischemic stroke patients treated within 24 hours of symptom onset, using hierarchical linear regression based on data from the stroke registry of the National Laboratory of Translational Neuroscience.
RESULTS: A total of 1,062 patients were included in this retrospective cohort (mean age 71.9 ± 12.6 years, 52% female). The full model explained 20% of the variance (R² = 0.20, p<0.001). Age (β = -0.25; p<0.001), diabetes mellitus (β = -4.12; p = 0.02), chronic kidney disease (β = -5.45; p = 0.03), and multiple vascular disease (β = -3.89; p = 0.04) emerged as independent negative predictors. Among the acute clinical variables, admission NIHSS (β = -1.78; p<0.001) and ASPECTS (β = +2.34; p = 0.01) showed independent associations with favorable functional outcome, whereas intravenous thrombolysis administered within 60 minutes (β = +4.56; p = 0.02) was a positive predictor and beyond 60 minutes (β = -3.67; p = 0.04) a negative predictor; similarly, endovascular thrombectomy within 120 minutes (β = +5.23; p< 0.001) was a positive, and beyond 120 minutes (β = -4.89; p = 0.03) a negative predictor. Recanalization showed an independent positive effect (β = +0.12; p = 0.04).
CONCLUSION: Our findings indicate that functional recovery is primarily determined by stroke severity, the extent of ischemic injury, and patient age, whereas metabolic and vascular comorbidities exert a moderate but statistically significant negative effect on outcome. The separated time windows for intravenous thrombolysis and endovascular treatment underscore the importance of in-hospital treatment speed, reduce exposure misclassification, and enhance the explanatory power of the model. A key strength of the hierarchical approach is its ability to incorporate predictors in successive blocks, allowing for a more precise evaluation of the multifactorial determinants of functional recovery. Orv Hetil. 2026; 167(2): 43-50.
PMID:41520307 | DOI:10.1556/650.2026.33457