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Introduction: There is limited data on the clinical significance of cerebral microbleeds (CMB) among patients with cerebral ischemia. The purpose of this study is to determine the prevalence of CMB in this population and assess the risk of in-hospital death.Methods: We analyzed consecutive stroke patients at two tertiary stroke centers in a two-year period. Patients without magnetic resonance imaging (MRI) or imaging confirmation of an ischemic stroke were excluded from this study. T2*-weighted MRIs were assessed for the number, location, and topography of CMBs as well as other acute and chronic cerebrovascular diseases. We compared the baseline characteristics and clinical information between patients with and without CMBs.Results: Out of 793 stroke patients evaluated in this study (mean age 62±14 years, 52% men, 60% African American, median admission NIHSS: 7), 127 patients (16%) had CMB on their brain imaging. Microbleeds were more prevalent among stroke patients with hypertension (OR: 2.3, 95% CI: 1.3-4.1), moderate-severe leukoaraiosis (OR 3.8, 95% CI: 1.6-6.2), and recurrent stroke (OR 1.7, 95% CI: 1.1-2.6). There was no significant difference between patients with and without CMBs in terms of sex, race, NIHSS, and discharge mRS. There was a trend toward higher risk of in-hospital mortality among patients with CMB and patients who had CMB in deep brain structures but neither reached a significant difference. However, the risk of in-hospital mortality was higher among patients with multiple (≥5) CMBs. After adjusting for potential confounders, the presence of ≥5 CMBs on T2*-MRI was independently (p<0.001) associated with a higher likelihood of in-hospital death (OR: 9.3, 95% CI: 3.0-29.2) in multivariable logistic regression analyses.Conclusion: Our results indicate that multiple CMBs are associated with higher mortality among stroke patients.