Long-Term Mortality According to the Characteristics of Early Neurological Deterioration in Ischemic Stroke Patients
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초록
Purpose: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristicsof END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemicstroke or transient ischemic attack patients. Materials and Methods: END was defined as any increase (≥1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between30-day or long-term mortality and each characteristic of END was investigatedusing multiple logistic analysis or Cox regression model. Results: Among 2820 patients, END was observed in 344 patients (12.2%). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was stronglyrelated to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality,as well as long-term mortality, while brain herniation and intracranial hemorrhagiccomplications were only associated with 30-day mortality. Conclusion: The results of the present study demonstrated that END is associated with higher mortalityand the effects of END on short-term and long-term mortality depend on END characteristics.
Abstract
Purpose: Although early neurological deterioration (END) during the acute stroke period is known to be associated with poor functional outcomes, there is little data regarding the impact of END on long-term outcomes according to the characteristicsof END. The aim of this study was to investigate whether there are differences in long-term mortality according to the characteristics of END among acute ischemicstroke or transient ischemic attack patients. Materials and Methods: END was defined as any increase (≥1) in National Institute of Health Stroke Scale score within 7 days after admission. We assessed the characteristics of END, such as the etiology and severity of END, as well as recovery after END. The relationship between30-day or long-term mortality and each characteristic of END was investigatedusing multiple logistic analysis or Cox regression model. Results: Among 2820 patients, END was observed in 344 patients (12.2%). After adjustment for age, sex, underlying cardiovascular diseases, stroke severity, and stroke subtypes, END was associated with long-term mortality, whether it was mild or severe and whether or not it was followed by recovery. However, 30-day mortality was stronglyrelated to the severity of END or the absence of recovery after END. Among the causes of END, recurrent stroke and medical illness were related to 30-day mortality,as well as long-term mortality, while brain herniation and intracranial hemorrhagiccomplications were only associated with 30-day mortality. Conclusion: The results of the present study demonstrated that END is associated with higher mortalityand the effects of END on short-term and long-term mortality depend on END characteristics.
참고문헌 (28)
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