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Prediction of long-term outcome by percent improvement after the first day of thrombolytic treatment in stroke patients.

DC Field Value Language
dc.contributor.author남효석-
dc.contributor.author안성환-
dc.contributor.author이경열-
dc.contributor.author이종윤-
dc.contributor.author한상원-
dc.contributor.author허지회-
dc.contributor.author김동익-
dc.contributor.author김동준-
dc.contributor.author김서현-
dc.contributor.author남정모-
dc.date.accessioned2015-04-24T16:40:06Z-
dc.date.available2015-04-24T16:40:06Z-
dc.date.issued2009-
dc.identifier.issn0022-510X-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/103946-
dc.description.abstractBACKGROUND: We investigated a method for assessing early improvement and predictive factors of early and late outcomes in patients receiving thrombolytic therapy. METHODS: A total of 160 consecutive patients who received thrombolytic therapy were included in the study. Using National Institutes of Health Stroke Scale (NIHSS) scores, percent improvement [(baseline NIHSS score-24-hour NIHSS score)/baseline NIHSS score x 100] was calculated and compared with delta (baseline NIHSS score-24-hour NIHSS score) and with major neurological improvement (MNI, NIHSS score of 0-1 or >or=8 point improvement at 24 h) by receiver operating characteristic (ROC) curve analysis. Finally, we investigated the independent predictors of improvement at 24 h after the thrombolytic therapy and of favorable 3-month outcome (modified Rankin scale score 0-2). RESULTS: By pairwise comparison of ROC curves, percent improvement was stronger than delta (p=0.004) and MNI (p<0.001) in predicting long-term outcome. First day improvement (FDI), defined as greater than 20% improvement, was a strong predictor of favorable 3-month outcome (OR 12.55, 95% CI 5.41-29.10). Recanalization (OR 3.30, 95% CI 1.28-8.45), absence of carotid T occlusion (OR 0.09, 95% CI 0.02-0.42) and hemorrhagic transformation (OR 0.25, 95% CI 0.09-0.73) were independent predictors of FDI. Independent predictors of favorable 3-month outcome were FDI, current smoking, absence of carotid T occlusion and hemorrhagic transformation. CONCLUSIONS: Percent improvement at 24 h after thrombolytic therapy is a useful surrogate marker for predicting the long-term outcome. Our findings highlight the importance of early stroke managemen-
dc.description.statementOfResponsibilityopen-
dc.format.extent69~73-
dc.relation.isPartOfJOURNAL OF THE NEUROLOGICAL SCIENCES-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHAtrial Fibrillation/complications-
dc.subject.MESHCarotid Artery Diseases/complications-
dc.subject.MESHFemale-
dc.subject.MESHFibrinolytic Agents/therapeutic use*-
dc.subject.MESHHumans-
dc.subject.MESHInjections, Intra-Arterial-
dc.subject.MESHInjections, Intravenous-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHROC Curve-
dc.subject.MESHSeverity of Illness Index-
dc.subject.MESHSmoking-
dc.subject.MESHStroke/complications-
dc.subject.MESHStroke/drug therapy*-
dc.subject.MESHStroke/physiopathology-
dc.subject.MESHThrombolytic Therapy*-
dc.subject.MESHTissue Plasminogen Activator/therapeutic use*-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHUrokinase-Type Plasminogen Activator/therapeutic use*-
dc.titlePrediction of long-term outcome by percent improvement after the first day of thrombolytic treatment in stroke patients.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Radiology (영상의학)-
dc.contributor.googleauthorHyo Suk Nam-
dc.contributor.googleauthorKyung-Yul Lee-
dc.contributor.googleauthorSang Won Han-
dc.contributor.googleauthorSeo Hyun Kim-
dc.contributor.googleauthorJong Yun Lee-
dc.contributor.googleauthorSeong Hwan Ahn-
dc.contributor.googleauthorDong Joon Kim-
dc.contributor.googleauthorDong Ik Kim-
dc.contributor.googleauthorChung Mo Nam-
dc.contributor.googleauthorJi Hoe Heo-
dc.identifier.doi10.1016/j.jns.2009.02.365-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01273-
dc.contributor.localIdA02648-
dc.contributor.localIdA03145-
dc.contributor.localIdA04369-
dc.contributor.localIdA00408-
dc.contributor.localIdA00410-
dc.contributor.localIdA00540-
dc.contributor.localIdA01264-
dc.contributor.localIdA04284-
dc.contributor.localIdA02238-
dc.relation.journalcodeJ01897-
dc.identifier.eissn1878-5883-
dc.identifier.pmid19304298-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0022510X09004444-
dc.subject.keywordIschemic stroke-
dc.subject.keywordThrombolysis-
dc.subject.keywordOutcome-
dc.subject.keywordROC curve-
dc.contributor.alternativeNameNam, Hyo Suk-
dc.contributor.alternativeNameAn, Sung Whan-
dc.contributor.alternativeNameLee, Kyung Yul-
dc.contributor.alternativeNameLee, Jong Yun-
dc.contributor.alternativeNameHan, Sang Won-
dc.contributor.alternativeNameHeo, Ji Hoe-
dc.contributor.alternativeNameKim, Dong Ik-
dc.contributor.alternativeNameKim, Dong Joon-
dc.contributor.alternativeNameKim, Seo Hyun-
dc.contributor.alternativeNameNam, Jung Mo-
dc.contributor.affiliatedAuthorNam, Hyo Suk-
dc.contributor.affiliatedAuthorLee, Kyung Yul-
dc.contributor.affiliatedAuthorLee, Jong Yun-
dc.contributor.affiliatedAuthorHeo, Ji Hoe-
dc.contributor.affiliatedAuthorKim, Dong Ik-
dc.contributor.affiliatedAuthorKim, Dong Joon-
dc.contributor.affiliatedAuthorKim, Seo Hyun-
dc.contributor.affiliatedAuthorNam, Jung Mo-
dc.contributor.affiliatedAuthorHan, Sang Won-
dc.contributor.affiliatedAuthorAn, Sung Whan-
dc.citation.volume281-
dc.citation.number1-2-
dc.citation.startPage69-
dc.citation.endPage73-
dc.identifier.bibliographicCitationJOURNAL OF THE NEUROLOGICAL SCIENCES, Vol.281(1-2) : 69-73, 2009-
dc.identifier.rimsid37903-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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