Background: Vascular and oncological diseases take one of the leading places in the structure of adult mortality. The existence of a relationship between these pathologies remains a subject of discussion.
The aim: Assess the relationship between risk factors, clinical course and outcome in patients with stroke and oncological comorbidity.
Methods: The study enrolled 2158 case histories of patients with acute cerebrovascular accident treated in our hospital in 2016. The combination of stroke and oncological comorbidity was observed in 61 cases (2.8 %). Patients with metastatic lesion and primary CNS tumors were excluded.
Results: The medium age of patients was 69±5.2 years (54% men). Ischemic stroke was observed in 88%, TIA in 3.3%, hemorrhagic stroke in 8.2% of cases. Stroke of the carotid artery was in 73%, vertebral artery in 16%. Recurrent stroke was observed in 37% cases. 10% of patients had history of myocardial infarction, 3.4% - pulmonary embolism. Frequency of vascular risk factors: arterial hypertension in 95%, carotid stenosis in 34%, coronary heart disease in 29%, peripheral artery disease in 15%, atrial fibrillation in 23.7%, diabetes mellitus in 25.4%. 6% patients had a body mass deficit. 49% of patients had an oncological anamnesis 1 year, 27% of patients from 1 to 5 years , 5 years - 24%. In 12% of cases oncology was detected fir the first time. Oncology was located in gastrointestinal tract (31%), lungs (11%), gynecological organs (13%). In 6.5% of cases there was multiple lesions. Atherothrombotic stroke was observed in 35.2% of cases, cardioembolic in 27.8%, lacunar in 3.7%. High frequency of cryptogenic stroke was noted (31.5%). Anemia was detected in half of patients of whom 17% were severe. Increased coagulation in the blood test was noted in 72.4% of patients. Mortality in the analyzed group was twice higher than in the general group. Among survived patients the proportion of patients with a Rankin score ≤ 2 was 41%, and in general group 56.2%. The length of stay in the hospital was 14.6 days in the analyzed group and 9.7 days in the general group.
Conclusion: The combination of stroke and oncology is a relatively rare variant of comorbidity. Hypercoagulation is important in the pathogenesis of ischemic stroke in combination with oncology. Oncopatology is a factor that worsens the course and prognosis of patients with stroke.