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Long-term mortality in patients with stroke of undetermined etiology

Authors
 Hyo Suk Nam  ;  Hyeon Chang Kim  ;  Young Dae Kim  ;  Hye Sun Lee  ;  Jinkwon Kim  ;  Dong Hyun Lee  ;  Ji Hoe Heo 
Citation
 Stroke, Vol.43(11) : 2948-2956, 2012 
Journal Title
 Stroke 
ISSN
 0039-2499 
Issue Date
2012
MeSH
Aged ; Female ; Humans ; Kaplan-Meier Estimate ; Korea/epidemiology ; Male ; Middle Aged ; Proportional Hazards Models ; Recovery of Function ; Registries ; Risk Factors ; Stroke/etiology* ; Stroke/mortality*
Keywords
Aged ; Female ; Humans ; Kaplan-Meier Estimate ; Korea/epidemiology ; Male ; Middle Aged ; Proportional Hazards Models ; Recovery of Function ; Registries ; Risk Factors ; Stroke/etiology* ; Stroke/mortality*
Abstract
BACKGROUND AND PURPOSE: The determination of stroke etiology is essential for planning treatment for stroke prevention. However, the etiology of stroke is undetermined in many patients. METHODS: During a 10-year period, consecutive patients with acute ischemic stroke were enrolled. The stroke etiology was determined based on the Trial of ORG 10172 in Acute Stroke Treatment classification. Long-term mortality and causes of death were identified using death certificates. The standardized mortality ratio was calculated to compare the mortality in patients with stroke and that in the general Korean population. RESULTS: In total, 3278 patients were enrolled and followed-up for a median of 3.4 years (interquartile range, 1.5-5.7). The stroke subtype was undetermined in 37% because of negative evaluation (21.2%), multiple causes (10.6%), and incomplete evaluation (4.8%). Poor functional outcome at 3 months (modified Rankin scale score >2) was more frequent in patients with an incomplete evaluation than in those with the other stroke subtypes (49.6% vs 24.5%; P<0.001). During follow-up, 781 patients (23.8%) died. The overall cumulative death rate was highest in patients with an incomplete evaluation (12.7% within 30 days, 25.5% within 1 year, and 35.7% within 3 years), followed by those with cardioembolism. Multivariate analysis after adjusting for covariates including initial stroke severity, the mortality of patients with an incomplete evaluation was second lowest after cardioembolism, whereas that in patients with a negative evaluation was low. CONCLUSIONS: Long-term mortality in patients with an incomplete evaluation was quite high. Etiologic work-up helps to better define the stroke subtype and determine the prognosis.
Files in This Item:
T201203485.pdf Download
DOI
22933583
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Lee, Dong Hyun(이동현)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91884
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