Background: Identifying pathophysiological mechanism of stroke is important for proper treatment. Causative Classification of Stroke (CCS) and TOAST are the mostly used classifications for maintaining underlying pathophysiology. Our aim was comparing these classifications in a large Turkish population.
Methods: Documents of 2096 patients who hospitalized with ischemic stroke (IS) and transient ischemic attack (TIA) between 2002-2005 were reviewed. Underlying mechanisms were determined by using CCS and TOAST. We compared the classifications to each other according to etiological findings of patients.
Results: There were 1893 IS and 203 TIA patients. 48% of IS, 46% of TIA according to CCS whereas 54.6% of IS, 95.6% of TIA according to TOAST were assigned as undetermined (p<0.001).
24.3% cardioembolism, 13.8% large artery atherosclerosis (LAA), 11.0% small artery occlusion (SAO), 3.5% more than one cause (MTOC) according to CCS whereas 21.8% cardioembolism, 10.2% LAA, 8.3% SAO, 4.4% MTOC according to TOAST were reported in IS (p<0.01).
12.8% cardioembolism, 16.7% LAA, 1.5% SAO, 2% MTOC according to CCS whereas 0.5% cardioembolism (p>0.01), 3% LAA (p<0.01), 0.5% SAO (p>0.01), 0.5% (p>0.01) according to TOAST were reported in TIA.
Other causes was found in 0,1% according to CCS, in 0.7% according to TOAST in IS (p>0.01). there was no any other causes in TIA patients.
Conclusion: Most frequent etiology was cardioembolism in IS, LAA in TIA whereas least frequent was others at both classifications. We thought that CCS reduces the proportion of undetermined etiology than TOAST in IS and TIA patients..