• Melih Yüksel, Halil Kaya, Mehmet Oğuzhan Ay, Demet Yıldız, Deniz Sığırlı, Aksel Özdemir, Fatma Betül Çalışkan, and Funda Yılmaz.
• Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey. melihdr@gmail.com.
• Ir J Med Sci. 2023 Feb 1; 192 (1): 409416409-416.

IntroductionThis study aims to prospectively examine patients with ischemic wake-up stroke (WUS) presenting to the emergency department, to investigate the risk factors affecting the mortality occurring within 28, 90, and 180 days, and to create a new scoring system for the prediction of 28-day mortality.Materials And MethodPatients who presented to the emergency department with WUS findings between 01.07.2019 and 30.06.2020 were prospectively analyzed. Logistic regression analysis was performed to determine the factors affecting mortality and the modified Rankin scale (mRS).ResultsA total of 161 patients were included. Of the patients, 22.4% died within 28 days and 40.4% within 180 days. The presence of coronary artery disease (CAD) increased the 28-day mortality risk (p = 0.009) 3.57 times, 90-day mortality risk 2.15 times (p = 0.033), and 180-day mortality risk 2.18 times (p = 0.045). In order to be used in the prediction of 28-day mortality in patients with WUS, we developed the ischemic WUS mortality score (IWUSMOS), which consists of the middle cerebral artery (45 points), internal carotid artery (60 points), basilar artery (39 points), superior cerebellar artery (66 points) occlusion, hypertension (33 points), CAD (28 points), malignancy (100 points), and arrhythmia (23 points). With this scoring system, the 28-day mortality risk was determined as 0.05% when the total score was "43" whereas the mortality risk was found to be 95.0% when the total score was "187."ConclusionWe propose that IWUSMOS, a new scoring system, can be used to predict the 28-day mortality risk of patients with WUS.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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