Anti-edema drugs and short-term mortality in older patients with acute ischemic stroke

Objectives: There are only few evidences concerning the possible effect of antiedema agents on stroke outcome. In this study we evaluated the effect of the treatment with intravenous (EV) glycerol or mannitol, and corticosteroids on short-term mortality (30 days) in a sample of older patients admitted to hospital for acute ischemic stroke. Methods: Data concerning 442 subjects (mean age 78.6 ± 8.9 years; 58.3% females) consecutively admitted to Internal Medicine and Geriatrics University Department for acute ischemic stroke have been collected with regard to clinical history, clinical and neurological examination, laboratory parameters, and brain computed tomography scan. Results: No reduction in the risk of death was observed in patients tre ated with EV glycerol; conversely, an increase in short-term mortality was observed in patients who were contemporary treated with EV corticosteroids. Mannitol treatment was not associated with a decrease in the risk of death too; the contemporary treatment with EV steroids was not associated with significant changes in mortality risk. The treatment with either glycerol or mannitol was not associated with a decrease in the risk of death, but the contemporary therapy with corticosteroids confirmed to be associated with an increased mortality risk. Conclusions: Our study does not support the effectiveness of EV glycerol or mannitol in reducing short-term mortality in older subjects with acute ischemic stroke; nevertheless, our data suggest a possible harmful effect of EV corticosteroids on short-term mortality.