{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:19:31Z","timestamp":1792685971664,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>We aimed to clarify the clinical characteristics and outcomes of patients with in-hospital onset ischemic stroke (IOS) compared with those in patients with community-onset ischemic stroke (COS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients from the Japan Stroke Data Bank, a hospital-based multicenter prospective registry, who were diagnosed with acute ischemic stroke (AIS) within 24\u2009h of onset between January 2001 and December 2020 were included in this study. We assessed favorable outcomes at discharge corresponding to a modified Rankin Scale (mRS) score of 0\u20132, unfavorable outcomes corresponding to an mRS score of 5\u20136, and mortality. We also examined trends in these outcomes at 4-year intervals over a period of 20\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 100,865 patients analyzed, 2979 had IOS (1416 women, mean age 77\u2009\u00b1\u200912\u2009years) and were older than those with COS (n\u2009=\u200997,886; 39,110 women, mean age 74\u2009\u00b1\u200912\u2009years). Multivariate analysis revealed that younger age, higher premorbid mRS score, absence of stroke history, normotension, congestive heart failure, coronary artery disease, chronic kidney disease, liver disease, malignancy, tendency to bleed, and cardioembolic stroke were positively associated with IOS. Compared with COS, IOS was inversely associated with a favorable outcome (42.1% vs 64.8%, adjusted odds ratio [aOR] 0.72 [95% confidence interval (CI) 0.63\u20130.82]), positively associated with an unfavorable outcome (mRS 5\u20136 at discharge; 34.3% vs 15.5%, aOR 1.31 [95% CI 1.16\u20131.48]), and mortality (11.8% vs 4.6%, aOR 1.59 [95% CI 1.37\u20131.84]). Over 20\u2009years, the mortality rate significantly decreased in both patients with IOS and COS (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01 both).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>IOS is associated with unfavorable outcomes and higher mortality rates during acute hospitalization. The mortality rates in patients with IOS decreased over time, similar to those observed in patients with COS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251350055","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T07:09:51Z","timestamp":1749193791000},"page":"1263-1270","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Characteristics and outcomes in patients with in-hospital stroke: Japan stroke data bank"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3605-0198","authenticated-orcid":false,"given":"Kotaro","family":"Usui","sequence":"first","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"},{"name":"Department of Neurology, Kitasato University, Sagamihara, Kanagawa, 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Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junpei","family":"Koge","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Ishigami","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Shiozawa","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3891-0221","authenticated-orcid":false,"given":"Yukako","family":"Yazawa","sequence":"additional","affiliation":[{"name":"Department of Stroke Neurology, Kohnan Hospital, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neurological Center, Ebina General Hospital, Ebina, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Okayama Kyokuto Hospital, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomichi","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Japanese Red 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