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Impact of Functional Status on Noncardioembolic Ischemic Stroke Recurrence Within 1 Year: The Korean Stroke Cohort for Functioning and Rehabilitation Study

Authors
 Min-Su Kim  ;  Min Cheol Joo  ;  Min Kyun Sohn  ;  Jongmin Lee  ;  Deog Young Kim  ;  Sam-Gyu Lee  ;  Yong-Il Shin  ;  Soo-Yeon Kim  ;  Gyung-Jae Oh  ;  Yang-Soo Lee  ;  Eun Young Han  ;  Junhee Han  ;  Jeonghoon Ahn  ;  Won Hyuk Chang  ;  Yun-Hee Kim 
Citation
 Journal of Clinical Neurology, Vol.15(1) : 54-61, 2019 
Journal Title
 Journal of Clinical Neurology 
ISSN
 1738-6586 
Issue Date
2019
Keywords
comorbidity ; disability evaluation ; function ; recurrence ; stroke
Abstract
BACKGROUND AND PURPOSE: Few studies have investigated the relationship between the specific functional factors potentially associated with functional level and stroke recurrence. We conducted a study of patients with noncardioembolic ischemic stroke (NCIS) to determine the functional factors affecting recurrence within the first year. METHODS: In total, 568 first-ever NCIS patients (age=65.1±17.4 years, mean±SD) were analyzed in a multicenter, prospective cohort study registered from August 2012. Demographic characteristics, past medical history, comorbidities, laboratory data, stroke features in neuroimaging, acute treatments, and medications at discharge were assessed. Functional factors reflecting gross functional impairment, ambulatory function, motor function, activities of daily living, cognition, language ability, swallowing function, mood, and quality of life were comprehensively evaluated in face-to-face assessments using standardized tools at the time of discharge. RESULTS: The cumulative incidence of stroke recurrence in NCIS was 6.0% (n=34) at 1 year. The period from admission to discharge was 34.4±7.0 days. The independent predictors of stroke recurrence within 1 year in multivariate Cox proportional-hazards regression analyses were 1) age [per-year hazard ratio (HR)=1.04, 95% confidence interval (CI)=0.97-1.06, p=0.048], 2) Charlson Comorbidity Index higher than 2 (HR=1.72, 95% CI=1.26-2.22, p=0.016), 3) modified Rankin Scale score of 3 or more at discharge (HR=1.56, 95% CI=1.22-1.94, p=0.032), and 4) Functional Ambulation Category of 3 or less at discharge (HR=2.56, 95% CI=1.84-3.31, p=0.008). CONCLUSIONS: In addition to patient age, moderate-to-severe functional impairment requiring the help of others (especially for ambulation) at the time of discharge and the severity of comorbidity were independent predictors of stroke recurrence within 1 year of the first NCIS.
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DOI
10.3988/jcn.2019.15.1.54
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
김덕용(Kim, Deog Young) ORCID logo https://orcid.org/0000-0001-7622-6311
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167472
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