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대학병원에 입원한 허혈뇌졸중 환자들의 10년간 임상특성의 시계열 변동 분석(1999~2008년)

The Secular Trends of Clinical Characteristics of Ischemic Stroke Patient Admitted to a University Hospitals for 10 Years Periods (1999-2008)

정민경|유경호|이병철|김주용|김윤중|주민경|오미선|마효일|김영은
대한뇌졸중학회 (The Korean Stroke Society)|2010.12|대한뇌졸중영문학회지 (Journal of stroke)|제12권 제3호|pp. 96-101

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참고문헌

키워드

Secular trendsIschemic stroke
주제분류신경과학

초록

Background: Major advances have been achieved in the diagnosis, prevention, and acute management of stroke patients during the last few decades. However, there are few data regarding the secular trends in ischemic stroke patients in Korea. We described the secular trends in the demographics, risk factors, sub-types, and outcomes over 10 years period (1999-2008) of ischemic stroke patients admitted to a referral hospital in a newly developed city in Korea. Methods: We assembled temporal trends of clinical characteristics through the following consecutive periods; 1999-2002, 2002-2005 and 2005-2008 among 2,218 consecutive ischemic stroke or transient ischemic attack patients within 7 days after onset of symptom Results: Five hundred fifty one patients were admitted in 1999-2002, 860 in 2002-2005, and 807 in 2005-2008, respectively. There was significant increase in the mean age at the stroke onset across the period (P=0.004), with an increase in the proportion of aged 80 years older (P=0.013). Through the 3 time periods, there was significant changes of stroke subtype (P<0.001); cardioembolic stroke increased significantly and small vessel disease decreased. In terms of vascular risk factors, the frequency of potential cardioembolic sources increased significantly (P=0.005), although the frequency of hyperlipidemia decreased (P<0.001). There was no difference in the in-hospital mortality and stroke severity across the periods. The proportions of patients who arrived within 3 hours after onset increased during the later period (P<0.001). Conclusion: Our study showed the secular trends in the clinical characteristics of acute ischemic stroke from 1999 to 2008 in a community-based university hospital in Korea. (Korean J Stroke 2010;12:96-101)

Abstract

Background: Major advances have been achieved in the diagnosis, prevention, and acute management of stroke patients during the last few decades. However, there are few data regarding the secular trends in ischemic stroke patients in Korea. We described the secular trends in the demographics, risk factors, sub-types, and outcomes over 10 years period (1999-2008) of ischemic stroke patients admitted to a referral hospital in a newly developed city in Korea. Methods: We assembled temporal trends of clinical characteristics through the following consecutive periods; 1999-2002, 2002-2005 and 2005-2008 among 2,218 consecutive ischemic stroke or transient ischemic attack patients within 7 days after onset of symptom Results: Five hundred fifty one patients were admitted in 1999-2002, 860 in 2002-2005, and 807 in 2005-2008, respectively. There was significant increase in the mean age at the stroke onset across the period (P=0.004), with an increase in the proportion of aged 80 years older (P=0.013). Through the 3 time periods, there was significant changes of stroke subtype (P<0.001); cardioembolic stroke increased significantly and small vessel disease decreased. In terms of vascular risk factors, the frequency of potential cardioembolic sources increased significantly (P=0.005), although the frequency of hyperlipidemia decreased (P<0.001). There was no difference in the in-hospital mortality and stroke severity across the periods. The proportions of patients who arrived within 3 hours after onset increased during the later period (P<0.001). Conclusion: Our study showed the secular trends in the clinical characteristics of acute ischemic stroke from 1999 to 2008 in a community-based university hospital in Korea. (Korean J Stroke 2010;12:96-101)

참고문헌 (35)

  1. 국민건강영양조사 제 4기 2차년도(2008) 결과보고서, "질병관리본부", 보건복지가족부, 2009
  2. Song YM, "Different risk factor profiles between subtypes of ischemic stroke. A case-control study in Korean men", Eur J Epidemiol, 20, pp.605~612 (2005)
  3. 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)
  4. 국민건강영양조사 제 3기 조사결과 심층분석연구: 건강면접 및 보건의식 부분, "질병관리본부", ~ (2007)
  5. 시도별 의료기관수-병원 및 의원, "보건복지부", ~
  6. 시도별종별 요양기관현황, "건강보험심사평가원", ~
  7. Lee BC, "The Hallym Stroke Registry: a web-based stroke data bank with an analysis of 1,654 consecutive patients with acute stroke", Eur Neurol, 54, pp.81~87 (2005)
  8. 유경호, "한국 뇌졸중 자료은행에 등록된 10,811명의 급성기 허혈성 뇌졸중 환자 분석: 병원기반 다의료기관 전향적 자료등록 연구", 대한신경과학회지, 24(6), pp.535~543 (2006), 대한신경과학회
  9. 이병철, "한림 뇌졸중 등록 자료를 통한 1,129명의 급성 뇌졸중 환자의 임상 양상", 대한뇌졸중학회지, 1(1), pp.21~27 (1999), 대한뇌졸중학회
  10. Lyden PD, "A modified National Institutes of Health Stroke Scale for use in stroke clinical trials: preliminary reliability and validity", Stroke, 32, pp.1310~1317 (2001)
  11. van Swieten JC, "Interobserver agreement for the assessment of handicap in stroke patients", Stroke, 19, pp.604~607 (1988)
  12. 장래인구추계, "통계청", ~ (2006)
  13. Saposnik G, "Stroke Outcome Research Canada (SORCan) Working Group. Stroke outcome in those over 80: a multicenter cohort study across Canada", Stroke, 39, pp.2310~2317 (2008)
  14. Goldstein LB, "American Heart Association", American Stroke Association Stroke Council; Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; Quality of Care and Outcomes Research Interdisciplinary Working Group; American Academy of Neurology. Primary prevention of ischemic stroke: a guideline from the American Heart Association, Stroke, pp.2006, 37[DOI]
  15. Rothwell PM, "Oxfored Vas-cular Study. Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study)", Lancet, 366, pp.1773~1783 (2005)
  16. Go AS, "Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the An Ticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study", JAMA, 285, pp.2370~2375 (2001)
  17. Jeong Joon Hoon, "Prevalence of and Risk Factors for Atrial Fibrillation in Korean Adults Older than 40 Years", Journal of Korean Medical Science, 20(1), pp.26~ (2005), 대한의학회
  18. Petty GW, "Ischemic stroke subtypes: a population-based study of incidence and risk factors", Stroke, 30, pp.2513~2516 (1999)
  19. Kimura K, "Japan Multicenter Stroke Investigator’s Collaboration. Analysis of 16,922 patients with acute ischemic stroke and transient ischemic attack in Japan. A hospital-based prospective registration study", Cerebrovasc Dis, 18, pp.47~56 (2004)
  20. Lavados PM, "Incidence, case-fatality rate, and prognosis of ischaemic stroke subtypes in a predominantly Hispanic-Mestizo population in Iquique, Chile (PISCIS project): a community-based incidence study", Lancet Neurology, 6, pp.140~148 (2007)
  21. Liu X, "Subtypes and one-year survival of first-ever stroke in Chinese patients: The Nanjing Stroke Registry", Cerebrovasc Dis, 22, pp.130~136 (2006)
  22. Yip PK, "Subtypes of ischemic stroke. A hospital-based stroke registry in Taiwan (SCAN-IV)", Stroke, 28, pp.2507~2512 (1997)
  23. SSYLVIA Study Investigators, "Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries (SSYLVIA): study results", Stroke, 35, pp.1388~1392 (2004)
  24. Wityk RJ, "Race and sex differences in the distribution of cerebral atherosclerosis", Stroke, 27, pp.1974~1980 (1996)
  25. Caplan LR, "Race, sex, and occlusive cerebrovascular disease: a review", Stroke, 17, pp.648~655 (1986)
  26. Takeya Y, "Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: incidence of stroke in Japan and Hawaii", Stroke, 15, pp.15~23 (1984)
  27. Carandang R, "Trends in incidence, lifetime risk, severity, and 30-day mortality of stroke over the past 50 years", JAMA, 296, pp.2939~2946 (2006)
  28. Kubo M, "Trends in the incidence, mortality, and survival rate of cardiovascular disease in a Japanese community: the Hisayama Study", Stroke, 34, pp.2349~2354 (2003)
  29. Wilterdink JL, "Effect of prior aspirin use on stroke severity in the trial of org 10172 in acute stroke treatment (TOAST)", Stroke, 32, pp.2836~2840 (2001)
  30. Greisenegger S, "Effect of pretreatment with statins on the severity of acute ischemic cerebrovascular events", J Neurol Sci, 221, pp.10~ (2004)
  31. 이재진, "뇌졸중에 대한 지식이 급성기 뇌졸중 환자들의 병원도착 전 시간 지연에 주는 영향", 대한신경과학회지, 27(2), pp.123~128 (2009), 대한신경과학회
  32. Katzan IL, "Cuyahoga County Operation Stroke. Cuyahoga County Operation Stroke speed of emergency department evaluation and com-pliance with National Institutes of Neurological Disorders and Stroke time targets", Stroke, 34, pp.994~998 (2003)
  33. Pessah-Rasmussen H, "Increasing st-roke incidence and decreasing case fatality, 1989-1998: a study from the stroke register in Malmö, Sweden", Stroke, 34, pp.913~918 (2003)
  34. Hallström B, "Stroke in Lund-Orup, Sweden: improved long-term survival among elderly stroke patients", Stroke, 33, pp.1624~1629 (2002)
  35. Howard G, "Decline in US stroke mortality: an analysis of temporal patterns by sex, race, and geographic region", Stroke, 32, pp.2213~2220 (2001)

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한림 뇌졸중 등록 자료를 통한 1,129명의 급성 뇌졸중 환자의 임상 양상이병철대한뇌졸중학회 · 대한뇌졸중영문학회지1999 · 제1권 제1호Increasing Frequency and Burden of Cerebral Artery Atherosclerosis in Korean Stroke Patients김영대, 남정모, 남효석, 조현지, 차명진, 최혜연, 한상원, 허지회연세대학교의과대학 · Yonsei Medical Journal2010 · 제51권 제3호증상발생 48시간 이내의 급성 뇌경색과 일과성허혈발작 환자에서 최근 4년간 내원 시간 단축과 관련된 요인구자성, 권오현, 김병건, 김석주, 박종무, 박지영, 이정주, 이지성대한신경과학회 · 대한신경과학회지2011 · 제29권 제2호Stroke Update 2009: Etiologies and Mechanisms of Ischemic Stroke방오영대한뇌졸중학회 · 대한뇌졸중영문학회지2009 · 제11권 제2호Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke강동화, 권순우, 방오영, 배희준, 오창완, 유경호, 윤병우, 이병철, 이진수, 허지회, 홍근식, Jong S. Kim대한뇌졸중학회 · 대한뇌졸중영문학회지2013 · 제15권 제2호90대 뇌졸중 환자의 임상적 특성강명찬, 박기정, 부선희, 서경화, 안태범, 윤성상, 이상범, 장대일, 정경천, 허성혁대한신경과학회 · 대한신경과학회지2007 · 제25권 제2호

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