일개 병원기반 코호트에서 관찰한 장기간의 뇌졸중 재발률
The Long-term Incidence of Recurrent Stroke: Single Hospital-based Cohort Study
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참고문헌
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초록
Background: Recurrent stroke is a major cause of morbidity and mortality among stroke survivors. However, studies of the long-term prognosis after acute stroke are very rare, especially in Asia. This study aimed to provide estimates of recurrent stroke rates by age, gender, and subtype of stroke in an unselected cohort of patients hospitalized to a community-based general hospital due to acute stroke. Methods: Based on a prospective stroke registry, acute stroke patients were enrolled within 7 days of symptom onset and followed retrospectively or prospectively for up to 3 years. Information was gathered about stroke recurrence and other vascular events. The cumulative risk of recurrent stroke was calculated using the Kaplan-Meier method. Results: Two-thousand and sixty-eight patients were enrolled in this study. The cumulative risks of stroke recurrence were 2.3%, 5.5%, 8.6%, and 10.0% at 90 days and 1, 2, and 3 years, respectively. The prevalence of stroke recurrence increased with age and the presence of previous stroke history (p<0.001), but not with gender or stroke subtype. Conclusions: To the best of our knowledge, this is the first cohort study of stroke recurrence in Korea. Its limitation of being a single hospital-based study warrants community- or multicenter-based cohort studies to identify high-risk groups for stroke recurrence.
Abstract
Background: Recurrent stroke is a major cause of morbidity and mortality among stroke survivors. However, studies of the long-term prognosis after acute stroke are very rare, especially in Asia. This study aimed to provide estimates of recurrent stroke rates by age, gender, and subtype of stroke in an unselected cohort of patients hospitalized to a community-based general hospital due to acute stroke. Methods: Based on a prospective stroke registry, acute stroke patients were enrolled within 7 days of symptom onset and followed retrospectively or prospectively for up to 3 years. Information was gathered about stroke recurrence and other vascular events. The cumulative risk of recurrent stroke was calculated using the Kaplan-Meier method. Results: Two-thousand and sixty-eight patients were enrolled in this study. The cumulative risks of stroke recurrence were 2.3%, 5.5%, 8.6%, and 10.0% at 90 days and 1, 2, and 3 years, respectively. The prevalence of stroke recurrence increased with age and the presence of previous stroke history (p<0.001), but not with gender or stroke subtype. Conclusions: To the best of our knowledge, this is the first cohort study of stroke recurrence in Korea. Its limitation of being a single hospital-based study warrants community- or multicenter-based cohort studies to identify high-risk groups for stroke recurrence.
참고문헌 (12)
- Mohr JP CD, "Stroke: Pathophysiology, Diagnosis, and Management. 4 ed", pp.42~ (2004), Churchill Livingstone
- Sacco RL, "Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study", Neurology, 44, pp.626~634 (1994)
- 신동훈, "뇌경색 아형군의 재발 기전: 추적 관찰 연구", 대한신경과학회지, 23(2), pp.158~164 (2005), 대한신경과학회
- 신대수, "재발된 뇌졸중의 중등도에 영향을 미치는 인자", 대한뇌졸중학회지, 4(1), pp.30~35 (2002), 대한뇌졸중학회
- Burn J, "Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project", Stroke, 25, pp.333~337 (1994)
- Petty GW, "Survival and recurrence after first cerebral infarction: a population-based study in Rochester, Minnesota, 1975 through 1989", Neurology, 50, pp.208~216 (1998)
- Hillen T, "Cause of stroke recurrence is multifactorial: patterns, risk factors, and outcomes of stroke recurrence in the South London Stroke Register", Stroke, 34, pp.1457~1463 (2003)
- Stroke, "Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders", Stroke, 20, pp.1407~1431 (1989)
- Adams HP Jr, "Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment", Stroke, 24, pp.35~41 (1993)
- Hankey GJ, "Long-term risk of first recurrent stroke in the Perth Community Stroke Study", Stroke, 29, pp.2491~2500 (1998)
- Dhamoon MS, "Recurrent stroke and cardiac risks after first ischemic stroke: the Northern Manhattan Study", Neurology, 66, pp.641~646 (2006)
- Kolominsky-Rabas PL, "Epidemiology of ischemic stroke subtypes according to TOAST criteria: incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study", Stroke, 32, pp.2735~2740 (2001)
