재발된 뇌졸중의 중등도에 영향을 미치는 인자

Abstract

Background : Predictors of recurrence after ischemic stroke are well known, but factors influencing on severity of recurrent stroke are not well known. The determinants of recurrent stroke severity will be of increasing importance because the frequency of ischemic stroke survivors increases in our population. Methods : Our, subjects included recurrent stroke patients who were admitted to the Chonnam Stroke Center between January 1997 and April 2001. Patients who had intracranial hemorrhage, vertebrobasilar insufficiency or transient ischemic attack were excluded. The severity of recurrent stroke was measured on admission by National Institutes of Health Stroke Scale(NIHSS) score and Modified-Barthel Index(MBI) score. We analyzed association of severity of recurrent stroke with confounders such as the way of secondary prevention, lesion laterality, type of ischemic stroke, risk factors of ischemic stroke by multiple linear regression. Results : Subjects were 63 patients(43 men and 20 women, aged 61.8¡¾11.5). The significant predictors of severity were medication of antiplatelet agent or anticoagulant(p<0.01) and lesion laterality of recurrent stroke(p<0.01). The severity of recurrent stroke was milder in patients who sustained medication(N=42) than who quitted medication(N=21). The severity of patients who had ipsilateral lesion(N=32) was milder than with had contralateral lesion N=31). Conclusions : The most significant independent predictor of the severity of recurrent stroke was whether medication was sustained or not. There fore, secondary prevention is extremely important for long term functional outcome of stroke victims. Korean Journal of Stroke 2002;4(1): 30~35