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류종헌,정원영 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1
Background and Objectives : The middle cerebral artery (MCA) territory infarction is the most common type of ischemic stroke and it plays an important role in mortality and severe disability after stroke. The aim of this study was to evaluate predictors of long-term outcome and cause of death after MCA infarction. Materials and Method : The author performed a retrospective study on 259 patients of MCA infarction who had been admitted to Chosun University Hospital in the period between 1993 and 1998. Among them, 68 cases that finished at least one-year of follow-up were selected from the Chosun Stroke Registry. The author evaluated the status of activity of daily living (ADL) by the modified Rankin scale (mRS). Thereafter the author assessed and compared the following potential predictors of outcome between the good prognosis group (mRS 3 or less) and the poor prognosis group (mRS 4, 5 and death):demographic data, risk factors of cerebrovascular accidents, clinical findings measured by modified the National Institute of Health scale (mNIH scale) at admission, laboratory findings, and neuroradiological findings. The statistical analysis was performed by means of the SPSS/PC package. Results : Of the 68 patients, 42 (62%) were male, and mean age at stroke onset was 67.6±11.3 years. By bivariate analysis, outcome was significantly related to age (p<001), systolic blood pressure level (p<05), and mNIH scale (p<001) at admission. The multiple regression analysis revealed that outcome depended on age (p<01) and mNIH scale (p<001) at admission. Thirty nine patients (57.4%) died during the follow-up period (28.9±14.5 months). The most common causes of death during the acute and chronic stages were stroke itself and poor general condition respectively. Conclusionr:Not only un-modifiable factors, such as age and degree of neurological deficit, but also modifiable factors, such as glucose level and blood pressure, were related with outcome in the MCA territory infarction. Because long-term survival was related to poor nursing care, further studies are needed to verify that proper rehabilitation program will help to improve outcome after large infarcts.
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